PDF(Pubmed)
Abstract：
Diabetic ketoacidosis (DKA) is a severe complication of diabetes mellitus characterized by hyperglycemia, metabolic acidosis, and ketosis. We present a challenging case of euglycemic DKA secondary to fasting and urinary tract infection with acute renal failure in a 50-year-old woman. Despite normal random blood sugar levels, the patient exhibited clinical signs of DKA, leading to further investigation. High anion gap metabolic acidosis with hyperkalemia and abnormal renal function tests were identified. After hemodialysis, serum ketones were found to be highly positive, confirming the diagnosis. Prompt management led to a complete clinical and laboratory resolution. This case underscores the importance of considering DKA in patients with suggestive symptoms, even with normal blood sugar levels.
摘要：
糖尿病酮症酸中毒（DKA）是糖尿病的严重并发症，以高血糖为特征，代谢性酸中毒,和酮症。我们提出了一个具有挑战性的病例，该病例继发于空腹和尿路感染并伴有急性肾功能衰竭的正常血糖DKA。尽管随机血糖水平正常，患者表现出DKA的临床症状，导致进一步调查。确定了高阴离子间隙代谢性酸中毒伴高钾血症和肾功能异常。血液透析后,血清酮被发现是高度阳性的，确认诊断。及时的管理导致了完整的临床和实验室解决方案。该病例强调了在有暗示性症状的患者中考虑DKA的重要性，即使血糖水平正常.
