The Interplay Between Diabetes and Pancreatitis: Two Case Reports of Sudden, Natural Deaths and a Review of the Literature

Butler, Caroline; Emanuel, J B S Anthony; Self, Sally; Batalis, Nicholas I.

doi:10.1111/1556-4029.13268

Cited by 3 publications

(1 citation statement)

References 28 publications

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“…Disebutkan juga bahwa beberapa faktor metabolik tertentu, seperti obesitas dan hipertrigliseridemia, meningkatkan risiko terjadi pankreatitis akut, yang disebut dengan pankreatitis akut metabolik, dan faktor-faktor ini meningkatkan risiko terjadinya diabetes melitus setelah pankreatitis akut. 13 Pankreatitis memang sering berhubungan dengan kondisi hiperglikemia dan korelasi ini merupakan suatu two causal relationship, yaitu pankreatitis menyebabkan terjadinya diabetes melitus, namun beberapa publikasi menyebutkan diabetes juga menimbulkan pankreatitis. Contohnya adalah hiperglikemia dapat membuat pasien pankreatitis akut memburuk ke arah gagal organ sistemik dan pasien diabetes memiliki risiko yang lebih tinggi untuk terjadi pankreatitis.…”

Section: Pembahasanunclassified

Penanganan pasien status hiperglikemik hiperosmoler yang disertai pankreatitis akut

Tersinanda

Suastika

2020

Intisari Sains Medis

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Introduction. The hyperosmolar hyperglycemic state is a dangerous complication that can arise with diabetes mellitus. The emergent treatment is necessary to reinstate hemodynamic stability, as mortality rates for the hyperosmolar hyperglycemic state are exceptionally high and can have multiple complications.Case. A 40-year-old male presented unresponsive to the emergency department. Upon arrival, the patient examination was consistent with dehydration and tachycardia. Review of systems included a one-week history of epigastrial pain, nausea and vomiting without a history of diabetes. The presenting blood sugar level was 1099 mg/dl with high osmolarity. Abdominal ultrasound revealed peripancreatic fluid suspicious for acute pancreatitis. Following successful treatment of acute pancreatitis and hyperglycemia with fluid and insulin, his serum glucose and pancreatic enzyme level decreased to normal range. The patient recovered and was discharged in stable condition.Conclusion. This case study postulates that the correlation between hyperosmolar hyperglycemic state and pancreatitis may be explained by two causal relationships, one of them is the hyperosmolar hyperglycemic state can be induced by ischemic pancreatitis. This is important because hyperglycemia superimposed on any ischemic insult can increase the risk of multiorgan failure, as with our patient. Thus, recognition and management of resulting complications need to be emergent. Pandahuluan. Status hiperglikemik hiperosmoler merupakan komplikasi berbahaya dari diabetes melitus. Terapi yang cepat sangat penting untuk mengembalikan stabilitas hemodinamik, dimana angka mortalitas untuk status hiperglikemik hiperosmoler sangat tinggi dan memiliki banyak komplikasi.Kasus. Seorang pria usia 40 tahun datang dalam keadaan penurunan kesadaran ke unit gawat darurat. Saat datang, pasien didapatkan dehidrasi dan takikardia dari pemeriksaan tanda vital. Didapatkan riwayat nyeri ulu hati sejak satu minggu, mual dan muntah tanpa riwayat diabetes sebelumnya. Kadar glukosa darah sewaktu saat itu 1099 mg/dl dengan osmolaritas yang tinggi. Dari pencitraan ultrasound abdomen didapatkan cairan peripankreatik yang mengarah ke pankreatitis akut. Dengan berhasilnya terapi cairan dan insulin untuk penanganan pankreatitis akut dan hiperglikemia, kadar glukosa darah dan enzim pankreas pasien ini membaik ke rentang normal. Kondisi pasien membaik dan dipulangkan dalam keadaan yang stabil.Kesimpulan. Laporan kasus ini menggambarkan korelasi antara status hiperglikemik hiperosmoler dan pankreatitis yang dapat dijelaskan dengan hubungan dua arah, dimana salah satunya bahwa status hiperglikemik hiperosmoler dapat dicetuskan oleh pankreatitis iskemik. Hal ini penting karena hiperglikemia yang dicetuskan oleh kondisi iskemik dapat meningkatkan risiko gagal multiorgan, seperti pada kasus ini. Sehingga, deteksi dan penanganan dari komplikasi ini harus dilakukan dengan segera.

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Section: Pembahasanunclassified

Penanganan pasien status hiperglikemik hiperosmoler yang disertai pankreatitis akut

Tersinanda

Suastika

2020

Intisari Sains Medis

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The possible protective effect of Nano-Selenium on the endocrine and exocrine pancreatic functions in a rat model of acute pancreatitis

Abdel-Hakeem

Abdel-Hamid

Hafez

2020

Journal of Trace Elements in Medicine and Biology

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Sudden Death in a Patient with Undiagnosed Diabetes, Acute Pancreatitis and Acute Adrenalitis

Jin¹,

Long²

2019

FMAR

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It has been well documented that acute pancreatitis and diabetic ketoacidosis (DKA) co-occur, and both of them present either as a cause or result of the other [1] [2]. Recently, hypertriglyceridemia has been reported to co-occur as well [3] [4]; the involvement of acute adrenalitis in the setting of acute pancreatitis and DKA has not been reported. We report a case of sudden death due to diabetic ketoacidosis, acute pancreatitis and acute adrenalitis in a 37-year-old female. She was found unresponsive and breathless in bed by her mother at their residence. At the time of the autopsy, both lungs were expanded and sigmoid diverticulosis was discovered on gross examination. Histology of the pancreas and the adrenal glands revealed acute inflammation despite appearing normal upon gross examination. The postmortem toxicology report showed high levels of acetone (12 mg/dL) in the postmortem blood and extremely high levels of glucose (>500 mg/dL) in the postmortem vitreous fluid. This is the first reported case of fatal diabetic ketoacidosis co-occurring with acute pancreatitis and acute adrenalitis.

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The Interplay Between Diabetes and Pancreatitis: Two Case Reports of Sudden, Natural Deaths and a Review of the Literature

Cited by 3 publications

References 28 publications

Penanganan pasien status hiperglikemik hiperosmoler yang disertai pankreatitis akut

Penanganan pasien status hiperglikemik hiperosmoler yang disertai pankreatitis akut

The possible protective effect of Nano-Selenium on the endocrine and exocrine pancreatic functions in a rat model of acute pancreatitis

Sudden Death in a Patient with Undiagnosed Diabetes, Acute Pancreatitis and Acute Adrenalitis

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