Caso contributivo
Chetoacidosi secondaria a tireotossicosi
in ragazza con diabete tipo 1 e celiachia
Type-1 diabetes mellitus and coeliac disease, with secondary ketoacidosis triggered by thyrotoxicosis: a case report
Vanna Graziani1, Andrea Zucchini2, Tosca Suprani3, Francesca Currò1, Lorenzo Mambelli1, Federico Marchetti1
1UOC di Pediatria e Neonatologia, Ospedale di Ravenna; 2Ospedale di Faenza; 3UOC di Pediatria e Neonatologia, Ospedale di Cesena, AUSL della Romagna
Marzo 2016
Abstract
The paper describes the case of a teenager affected by type 1 diabetes mellitus and coeliac disease who presented sec- ondary ketoacidosis (DKA) triggered by thyrotoxicosis. She was successfully treated with beta-blocker and methimazole, in addi- tion to intravenous insulin therapy. The association of thyrotoxi- cosis and DKA is uncommon but anecdotal cases are reported in literature. Through different mechanisms hyperthyroidism may cause decreased levels of insulin and increased glycogenolysis, ketogenesis, dehydration, and insulin resistance. The possibility of DKA triggered by thyrotoxicosis should be kept in mind in fe- male patient or in the presence of symptoms of hyperthyroidism.
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Bibliografia
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