Is It Really Diabetic Ketoacidosis? Double Trouble

Abstract

Introduction: In a patient admitted to the emergency service with complaints of nausea, vomiting, polydipsia, and polyuria and with findings of hyperglycemia, ketonemia, and acidosis, the first diagnosis to be considered is diabetic ketoacidosis (DKA). DKA is more common among young patients, of whom 50% to 85% are adults. Uremia, lactic acidosis, and intoxication with drugs and substances, such as salicylates, methanol, paraldehyde, and ethylene glycol, may present clinically as diabetic ketoacidosis.Case Report: In this paper, we presented an 18-year-old patient who was first treated with the diagnosis of DKA and was diagnosed with salicylate intoxication afterwards during the emergency service follow-up. Conclusion: The final diagnosis and necessary treatment might be impeded in such patients if the treatment is initiated considering DKA. Thus, when the clinical findings cannot be explained with the history, physical exam, and laboratory tests, intoxication with drugs, particularly with easily accessible salicylates, should be undoubtedly considered

Keywords

• Diabetic ketoacidosis, salicylate, intoxication

Gerçekten Diyabetik Ketoasidoz mu? Çifte Bela

Abstract

Introduction: In a patient admitted to the emergency service with complaints of nausea, vomiting, polydipsia, and polyuria and with findings of hyperglycemia, ketonemia, and acidosis, the first diagnosis to be considered is diabetic ketoacidosis (DKA). DKA is more common among young patients, of whom 50% to 85% are adults. Uremia, lactic acidosis, and intoxication with drugs and substances, such as salicylates, methanol, paraldehyde, and ethylene glycol, may present clinically as diabetic ketoacidosis.   Case Report: In this paper, we presented an 18-year-old patient who was first treated with the diagnosis of DKA and was diagnosed with salicylate intoxication afterwards during the emergency service follow-up.   Conclusion: The final diagnosis and necessary treatment might be impeded in such patients if the treatment is initiated considering DKA. Thus, when the clinical findings cannot be explained with the history, physical exam, and laboratory tests, intoxication with drugs, particularly with easily accessible salicylates, should be undoubtedly considered.

Keywords

• Diabetic ketoacidosis, salicylate, intoxication

References

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