Non-diabetic ketoacidosis secondary to primary hyperthyroidism
<h3>Introduction</h3><p dir="ltr">There are variable complications of hyperthyroidism, including atrial fibrillation, heart failure, osteoporosis, and thyroid storm. One infrequent complication of hyperthyroidism is non-diabetic ketoacidosis (NDKA). To the best of our kno...
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| مؤلفون آخرون: | , , , |
| منشور في: |
2022
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إضافة وسم
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| _version_ | 1864513548689866752 |
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| author | Abdulrahman F. Al-Mashdali (17148316) |
| author2 | Mohammadshah Gul (21348002) Waseem Umer (13569761) Abeer Omar (7873610) Akhnuwkh Jones (20321835) |
| author2_role | author author author author |
| author_facet | Abdulrahman F. Al-Mashdali (17148316) Mohammadshah Gul (21348002) Waseem Umer (13569761) Abeer Omar (7873610) Akhnuwkh Jones (20321835) |
| author_role | author |
| dc.creator.none.fl_str_mv | Abdulrahman F. Al-Mashdali (17148316) Mohammadshah Gul (21348002) Waseem Umer (13569761) Abeer Omar (7873610) Akhnuwkh Jones (20321835) |
| dc.date.none.fl_str_mv | 2022-06-10T09:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1097/md.0000000000028253 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Non-diabetic_ketoacidosis_secondary_to_primary_hyperthyroidism/29045471 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Clinical sciences Medical biochemistry and metabolomics Pharmacology and pharmaceutical sciences case report hyperthyroidism metabolic acidosis non-diabetic ketoacidosis thyrotoxicosis |
| dc.title.none.fl_str_mv | Non-diabetic ketoacidosis secondary to primary hyperthyroidism |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Introduction</h3><p dir="ltr">There are variable complications of hyperthyroidism, including atrial fibrillation, heart failure, osteoporosis, and thyroid storm. One infrequent complication of hyperthyroidism is non-diabetic ketoacidosis (NDKA). To the best of our knowledge, our case is the third report of NDKA related to thyrotoxicosis.</p><h3>Patient concern</h3><p dir="ltr">We describe a case of a 41-year-old African lady with no past medical history presented to our hospital with severe abdominal pain and vomiting for three weeks. This was associated with decreased appetite and weight loss.</p><h3>Diagnosis</h3><p dir="ltr">Laboratory findings were significant for high anion gap metabolic acidosis, positive ketones in the urine, and high serum B-hydroxybutyrate. The blood glucose readings and HbA1c were within normal limits. Also, serum lactic acid and salicylate levels were within the normal range. The diagnosis of NDKA was made. Later, the thyroid functions test (TFT) confirmed the diagnosis of primary hyperthyroidism.</p><h3>Intervention and outcomes</h3><p dir="ltr">The patient was managed initially with intravenous fluid and antiemetics. Then, she was started on propranolol and carbimazole. After which, her symptoms improved dramatically, and the metabolic acidosis (with serum ketones) were corrected within a few days of starting anti-thyroid medications.</p><h3>Conclusion</h3><p dir="ltr">Despite its rarity, NDKA can be associated with severe thyrotoxicosis. Vigorous intravenous hydration and anti-thyroid medication are the mainstay treatment. TFT should be requested in a patient with unexplained NDKA</p><h2>Other Information</h2><p dir="ltr">Published in: Medicine<br>License: <a href="http://creativecommons.org/licenses/by/4.0" target="_blank">http://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1097/md.0000000000028253" target="_blank">https://dx.doi.org/10.1097/md.0000000000028253</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_be18519ff3e8e1c8cdc252994aa5b137 |
| identifier_str_mv | 10.1097/md.0000000000028253 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/29045471 |
| publishDate | 2022 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Non-diabetic ketoacidosis secondary to primary hyperthyroidismAbdulrahman F. Al-Mashdali (17148316)Mohammadshah Gul (21348002)Waseem Umer (13569761)Abeer Omar (7873610)Akhnuwkh Jones (20321835)Biomedical and clinical sciencesClinical sciencesMedical biochemistry and metabolomicsPharmacology and pharmaceutical sciencescase reporthyperthyroidismmetabolic acidosisnon-diabetic ketoacidosisthyrotoxicosis<h3>Introduction</h3><p dir="ltr">There are variable complications of hyperthyroidism, including atrial fibrillation, heart failure, osteoporosis, and thyroid storm. One infrequent complication of hyperthyroidism is non-diabetic ketoacidosis (NDKA). To the best of our knowledge, our case is the third report of NDKA related to thyrotoxicosis.</p><h3>Patient concern</h3><p dir="ltr">We describe a case of a 41-year-old African lady with no past medical history presented to our hospital with severe abdominal pain and vomiting for three weeks. This was associated with decreased appetite and weight loss.</p><h3>Diagnosis</h3><p dir="ltr">Laboratory findings were significant for high anion gap metabolic acidosis, positive ketones in the urine, and high serum B-hydroxybutyrate. The blood glucose readings and HbA1c were within normal limits. Also, serum lactic acid and salicylate levels were within the normal range. The diagnosis of NDKA was made. Later, the thyroid functions test (TFT) confirmed the diagnosis of primary hyperthyroidism.</p><h3>Intervention and outcomes</h3><p dir="ltr">The patient was managed initially with intravenous fluid and antiemetics. Then, she was started on propranolol and carbimazole. After which, her symptoms improved dramatically, and the metabolic acidosis (with serum ketones) were corrected within a few days of starting anti-thyroid medications.</p><h3>Conclusion</h3><p dir="ltr">Despite its rarity, NDKA can be associated with severe thyrotoxicosis. Vigorous intravenous hydration and anti-thyroid medication are the mainstay treatment. TFT should be requested in a patient with unexplained NDKA</p><h2>Other Information</h2><p dir="ltr">Published in: Medicine<br>License: <a href="http://creativecommons.org/licenses/by/4.0" target="_blank">http://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1097/md.0000000000028253" target="_blank">https://dx.doi.org/10.1097/md.0000000000028253</a></p>2022-06-10T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1097/md.0000000000028253https://figshare.com/articles/journal_contribution/Non-diabetic_ketoacidosis_secondary_to_primary_hyperthyroidism/29045471CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/290454712022-06-10T09:00:00Z |
| spellingShingle | Non-diabetic ketoacidosis secondary to primary hyperthyroidism Abdulrahman F. Al-Mashdali (17148316) Biomedical and clinical sciences Clinical sciences Medical biochemistry and metabolomics Pharmacology and pharmaceutical sciences case report hyperthyroidism metabolic acidosis non-diabetic ketoacidosis thyrotoxicosis |
| status_str | publishedVersion |
| title | Non-diabetic ketoacidosis secondary to primary hyperthyroidism |
| title_full | Non-diabetic ketoacidosis secondary to primary hyperthyroidism |
| title_fullStr | Non-diabetic ketoacidosis secondary to primary hyperthyroidism |
| title_full_unstemmed | Non-diabetic ketoacidosis secondary to primary hyperthyroidism |
| title_short | Non-diabetic ketoacidosis secondary to primary hyperthyroidism |
| title_sort | Non-diabetic ketoacidosis secondary to primary hyperthyroidism |
| topic | Biomedical and clinical sciences Clinical sciences Medical biochemistry and metabolomics Pharmacology and pharmaceutical sciences case report hyperthyroidism metabolic acidosis non-diabetic ketoacidosis thyrotoxicosis |