Euglycemic Diabetic Ketoacidosis in a Patient Post Cardiac Surgery Receiving Continuous Renal-Replacement Therapy

Euglycemic diabetic ketoacidosis is an often-underrecognized endocrine emergency. We highlight an unusual presentation of euglycemic diabetic ketoacidosis in a patient with a history of hypertension, type 2 diabetes mellitus, and stage 3b chronic kidney disease who had elective aortic and mitral val...

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Bibliographic Details
Main Authors: Walter Yaw Agyeman, Inemesit Akpan, Kwasi Opare-Addo, Saheed Soleye, Alfred Solomon
Format: Article
Language:English
Published: American College of Physicians 2023-10-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2023.0663
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Summary:Euglycemic diabetic ketoacidosis is an often-underrecognized endocrine emergency. We highlight an unusual presentation of euglycemic diabetic ketoacidosis in a patient with a history of hypertension, type 2 diabetes mellitus, and stage 3b chronic kidney disease who had elective aortic and mitral valve–replacement surgery. She developed acute kidney injury requiring temporary continuous renal-replacement therapy. Despite hemodialysis, the patient had persistent anion-gap metabolic acidosis. Additional evaluation resulted in the diagnosis of euglycemic diabetic ketoacidosis. Successful care in this patient population entails a high index of suspicion, early diagnosis, and appropriate management.
ISSN:2767-7664