Case report of superior mesenteric artery syndrome that developed in a lean type 2 diabetes patient and was associated with rapid body weight loss after sodium-glucose cotransporter 2 inhibitor administration.

A 58-year-old women who was diagnosed with type 2 diabetes 20 years earlier had been treated with antidiabetic medicines since she was aged 40 years. After sodium-glucose cotransporter 2 inhibitors administration, her bodyweight rapidly decreased from 40 to 30 kg over a period of 3 weeks. She had abdominal symptoms, including nausea, especially after a meal. On admission, physical examinations and laboratory data showed euglycemic ketoacidosis, dehydration and low insulin secretion levels. Additionally, abdominal contrast computed tomography showed the finding of superior mesenteric artery syndrome. This case urges caution, including rapid excessive bodyweight loss and euglycemic ketoacidosis, on the use of sodium-glucose cotransporter 2 for lean diabetes patients.

The superior mesenteric artery syndrome: an unusual complication in a patient with the Hallervorden-Spatz syndrome.

A 12 year old patient with the Hallervorden-Spatz syndrome and suffering from acute intestinal obstruction during treatment with benztropine is presented. An upright film of the abdomen and opacification of the duodenum showed an abrupt cut off just to the right of the third lumbar vertebra. Abdominal ultrasound demonstrated a reduced superior mesenteric-aortic angle and distance. Predisposing factors in this patient were supine position, extreme opisthotonos and duodenal hypotonia induced by benztropine.