Diabetic Ketoacidosis, Hypertriglyceridemia and Abdominal Pain due to Acute Pancreatitis Complicated by Non-immune Haemolytic Anaemia

  • Monica Joustra Department of Internal Medicine, Ziekenhuisgroep Twente (Hospital Group Twente), Almelo, The Netherlands
  • Janneke Raidt Department of Internal Medicine, Ziekenhuisgroep Twente (Hospital Group Twente), Almelo, The Netherlands
  • Florens Droog Department of Intensive Care Medicine, Ziekenhuisgroep Twente (Hospital Group Twente), Almelo, The Netherlands
  • Thiemo Veneman Department of Intensive Care Medicine, Ziekenhuisgroep Twente (Hospital Group Twente), Almelo, The Netherlands

Keywords

Acute pancreatitis, diabetes ketoacidosis, hypertriglyceridemia, haemolytic anaemia

Abstract

The triad of diabetic ketoacidosis, acute pancreatitis and hypertriglyceridemia is a rare phenomenon, with mortality rates of up to 80%. A unique characteristic of the described case is the co-occurrence of non-immune haemolytic anaemia (NIHA) with the complex triad. It is suggested that this presentation is secondary to hyperlipidemia which leads to increased fragility of erythrocytes due to destabilization of red cell membranes.
Supportive treatment with intravenous insulin and blood transfusions is the cornerstone of treatment.

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References

  • Roberto Simons-Linares C, Jang S, Sanaka M, Bhatt A, Lopez R, Vargo J, et al. The triad of diabetes ketoacidosis, hypertriglyceridemia and acute pancreatitis. How does it affect mortality and morbidity?: A 10-year analysis of the National Inpatient Sample. Medicine 2019;98(7):e14378.
  • Druml W, Laggner AN, Lenz K, Grimm G, Schneeweiss B. Pancreatitis in acute hemolysis. Ann Hematol 1991;63(1):39–41.
  • Yadav D, Nair S, Norkus EP, Pitchumoni CS. Nonspecific hyperamylasemia and hyperlipasemia in diabetic ketoacidosis: incidence and correlation with biochemical abnormalities. Am J Gastroenterol 2000;95(11):3123–3128.
  • Kota SK, Krishna SV, Lakhtakia S, Modi KD. Metabolic pancreatitis: etiopathogenesis and management. Indian J Endocrinol Metab 2013;17:799–805.
  • Dimeski G, Mollee P, Carter A. Increased lipid concentration is associated with increased hemolysis. Clin Chem 2005;51(12):2425.
  • Tariq R, Khanna S. Hemolyzed blood as a clue to the diagnosis of abdominal pain. Intern Emerg Med 2016;11(4):609–610.
  • Published: 2020-12-09

    Issue: Vol 7 No 12 (view)

    Section: Articles

    How to cite:
    1.
    Joustra M, Raidt J, Droog F, Veneman T. Diabetic Ketoacidosis, Hypertriglyceridemia and Abdominal Pain due to Acute Pancreatitis Complicated by Non-immune Haemolytic Anaemia. EJCRIM 2020;7 doi:10.12890/2020_002085.

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