糖尿病酮症酸中毒致高甘油三脂血症性胰腺炎一例报道

Hypertriglyceridemic pancreatitis caused by diabetic ketoacidosis:a case report

12岁患儿因呕吐、腹痛、气促嗜睡入院。实验室检查示血糖、尿糖、尿酮体、尿淀粉酶升高,酸中毒。血呈乳糜微粒状,TG明显升高。腹部CT支持胰腺炎表现。基因检测结果示患儿低密度脂蛋白受体基因存在c.1516G>A杂合突变。诊断患儿DKA致高甘油三脂血症性胰腺炎(HTGP)。给予禁食、Ins、血浆置换及药物降脂治疗后,患儿血脂、血糖正常。DKA致HTGP在儿童发病率低,临床医生认识不足,早期发现并积极降脂治疗有助于减轻临床症状并改善预后。

A 12-year-old girl was admitted to the hospital due to vomiting,abdominal pain and shortness of breath.The clinical manifestations were mid-upper abdominal pain with deep breathing and drowsiness.Laboratory tests showed elevated blood glucose,elevated urinary glycosuria,acidosis,and elevated urine amylase.The blood sample was in the form of chylomicrons,and blood triglycerides were significantly elevated.Abdominal CT supports pancreatitis.Genetic testing showed that there was a c.1516 G>A heterozygous mutation in the LDLR gene.She was diagnosed with hypertriglyceridemic pancreatitis(HTGP)caused by diabetic ketoacidosis(DKA).After fasting,insulintherapy,plasma exchange and drug lipid-lowering therapy,the blood lipids and glucose fell to normal levels.DKA-induced HTGP is rare in children.Clinicians are not sufficiently aware of this disease.Early detection and active lipid-lowering therapy can help reduce clinical symptoms and improve prognosis.