Endocrine Abstracts

Introduction

Acute pancreatitis (AP) is the most common affection of the pancreas, it often leads to glycemic disorders. On the other hand, diabetic ketoacidosis (DKA) is associated with nonspecific increase in serum amylase levels. The aim of this study was to evaluate the clinical characteristics of acute AP concomitant with DKA.

Methods

We conducted a retrospective and descriptive analysis of clinical records of patients diagnosed with DKA and AP, between 2000 and 2020 in endocrinology department. All patients fulfilled the current diagnostic criteria of both, DKA and AP. Clinical, biological and radiological data were collected.

Results

A total of 18 patients (7 males and 11 females) were enrolled in the study. The mean age was 40 years, ranging from 16 to 70 years. Of 18 patients, 11 had prior history of diabetes and five had hyperlipidemia. Two patients had a history of alcohol use. All the patients presented nausea and vomiting at time of admission. Abdominal pain was absent in five patients and four were comatose on admission. The mean BMI was 26.6 kg/m². Both serum amylase and lipase levels were elevated in all patients with a mean value of 324 (NR: 10–45 UI/l) and 272 UI/l (NR:10–60 UI/l) respectively. AP confirmed by an abdominal computed tomography (CT) scan finding was occurred in 16 patients. The etiology of acute pancreatitis was gallstone in five, hypertriglyceridemia in two, and idiopathic in eleven patients.

Conclusions

Although DKA can be associated with elevated amylase and lipase in 16–25% of cases, acute pancreatitis may co-exist with DKA in at least 10–15% of DKA patients [1]. The pathogenesis of AP in DKA varies, but at least in some transient and profound hyperlipidemia is an identifiable factor. AP is more likely in severe DKA with significant acidosis and hyperglycemia.

Reference

1. 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; 95:3123–3128.