Endocrine Abstracts

Background: We would like to present a case of pancreatic encephalopathy induced by DKA induced hypertriglyceridemia. The triad of acute pancreatitis, hypertriglyceridemia and diabetes is a rare occurrence. Through our case we aim to highlight the importance of making an early diagnosis as a delay in diagnosis can worsen outcomes.

Case history: We present the case of a 51 year old Type 2 Diabetic non compliant with her medications who was admitted to the emergency department with abdominal pain and generally feeling unwell. She was diagnosed as having Diabetic Ketoacidosis based on her venous blood gases and capillary ketones and started on appropriate treatment. The patient started to become more drowsy and hence had to be admitted to the intensive care unit for investigating the cause of her drowsiness and to support her airway.

Investigations and Treatment: Bloods done revealed evidence of increased Triglycerides and high lipase. She had a CT head done which showed no evidence of acute abnormalities. CT abdomen revealed evidence of peripancreatic free fluid suggesting pancreatitis. Subsequently she had a Lumbar puncture done to rule out evidence of CNS infection which was normal. The patient improved during her stay in the ICU with closed monitoring and had a full recovery.

Conclusion: Hypertriglyceridemia is associated with more complications and poor outcomes. Acute pancreatitis can be induced by diabetic ketoacidosis (DKA), complicated by hypertriglyceridemia. However, and to the best of our knowledge, the association of this triad of pancreatitis, hypertriglyceridemia, and diabetic ketoacidosis and its treatment has not been widely discussed in the literature. Rapid diagnosis is difficult due to overlapping signs, but it is crucial for adequate management.