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Source publication
Diabetic ketoacidosis (DKA) is the most common life-threatening complication of diabetes, especially in type 1 diabetes mellitus (T1DM). Severe dyslipidaemia causing extensive xanthomas is very rarely reported in DKA. We report the case of a 30-year-old male with T1DM who presented with features of ketoacidosis and had extensive eruptive xanthomas....
Context in source publication
Context 1
... examinations were unremarkable. Blood samples drawn for laboratory examination appeared grossly lipemic (Figure 2). Serum chemistry analysis revealed abnormal values for triglyceride (75.6 mmol/L, reference range 0.4-1.52 mmol/L), total cholesterol (28.2 mmol/L, reference range 0-5.2 mmol/L), high-density lipoprotein (HDL) cholesterol (0.1 mmol/L, reference range > 0.9 mmol/L) and low-density lipoprotein (LDL) cholesterol could not be estimated using the Friedewald formula (the Friedewald formula is inaccurate at extremely high triglyceride and total cholesterol levels). ...
Citations
... Early initiation of lipid-lowering agents can expedite the resolution of cutaneous lesions and substantially mitigate the risk of severe complications such as pancreatitis, along with attenuating longterm cardiovascular risks. 13 After treatment of underlying metabolic disorder, xanthomatous lesions mostly disappear without leaving scars. If the medical treatment fails to resolve the lesions surgery, laser or cryosurgery are therapeutic alternatives. ...
Key Clinical Message
Managing diabetic ketoacidosis (DKA) in individuals with severe dyslipidemia necessitates a comprehensive approach. While rehydration and continuous insulin infusion are fundamental components of DKA management due to the underlying insulin deficiency, the presence of severe hyperlipidemia with eruptive xanthomas warrants additional consideration. Early initiation of lipid‐lowering agents can expedite the resolution of cutaneous lesions and substantially mitigate the risk of severe complications such as pancreatitis, along with attenuating long‐term cardiovascular risks.
Abstract
Xanthomas are the benign lesions which are generated by localized lipid deposits in the skin, tendons, and subcutaneous tissue. They appear clinically as yellowish papules, nodules, or plaques. Acute pancreatitis and eruptive xanthomas can occur as complications of hyperlipidemia. Uncontrolled diabetes mellitus in one of the risk factors for hypertriglyceridemia. Early recognition and treatment of the eruptive xanthomatosis as a warning sign of hypertriglyceridemia can decrease the morbidity and mortality due to acute pancreatitis. Here, we discuss a case of 37‐years old female patient with uncontrolled type II diabetes mellitus presented with acute pancreatitis and eruptive xanthomas as result of raised triglycerides and uncontrolled diabetes.
