Painless Acute Pancreatitis Associated with Diabetic Ketoacidosis in a Case of Juvenile Onset Obese Non-Insulin-Dependent Diabetes Mellitus.
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Accession number;99A0455006
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| Title;Painless Acute Pancreatitis Associated with Diabetic Ketoacidosis in a Case of Juvenile Onset Obese Non-Insulin-Dependent Diabetes Mellitus. |
| Author;
YAMAGUCHI KOHEI
(Oita Prefect. Hosp.)
KAYASHIMA TOORU
(Oita Prefect. Hosp.)
HASHIGUCHI YASUHIRO
(Oita Prefect. Hosp.)
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Journal Title;Journal of the Japan Diabetic Society
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Journal Code:Z0279B
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ISSN:0021-437X
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VOL.42;NO.2;PAGE.163-168(1999)
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| Figure&Table&Reference;FIG.3, TBL.2, REF.23 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;This is a report of a case of acute pancreatitis associated with diabetic ketoacidosis(DKA) in which abdominal pain was completely absent throughout the entire clinical course. The patient was a 15-year-old boy, 180cm in height and weighing 100kg, who had complained of flu-like symptoms for 10 days prior to admission. Despite treatment by a local doctor, the boy's general state had deteriorated and his consciousness level gradually declined. He was admitted to our department as an emergency case. Arterial blood gas analysis revealed marked metabolic acidosis (pH7.07, base excess -25.8mmol/l). Urinary ketone bodies were 3+ and fasting plasma glucose was 970mg/dl. A diagnosis of DKA was made and treatment commenced with saline infusion and continuous insulin infusion, which resulted in a marked improvement in level of consciousness. Within the first hospital day, the patient became alert, but on the third hospital day, fever and markedly high levels of CRP were exhibited, and serum amylase was moderately elevated. Despite absence of abdominal pain, an abdominal CT scan was performed and revealed evidence of typical acute pancreatitis. Following a course of fasting and administration of Nafamostat, the boy recovered. The pathogenesis of his pancreatitis is considered to be marked hypertriglyceridemia (1,158mg/dl) due to DKA. These findings are noteworthy and indicate that acute pancreatitis associated with DKA may be completely painless. (author abst.) |
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