Autoimmune Pancreatitis, Diabetic Ketoacidosis, and Severe Hypertriglyceridemia: Unraveling a Pathophysiological Triad
Abstract
Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis and an uncommon cause of recurrent acute pancreatitis. Although diabetes mellitus is a frequent manifestation of AIP, presentation as diabetic ketoacidosis (DKA) is exceptional. The coexistence of DKA and severe hypertriglyceridemia (HTG) in the setting of AIP represents a rare clinical association with important diagnostic and therapeutic implications. A 43-year-old man with type 2 diabetes mellitus and two previous episodes of HTG-associated acute pancreatitis presented with severe epigastric pain, persistent vomiting, and Kussmaul respiration. Laboratory investigations revealed moderate DKA (pH, 7.12; bicarbonate, 12 mmol/L), severe HTG (16.0 g/L), and markedly elevated serum lipase (600 IU/L). Contrast-enhanced abdominal CT demonstrated diffuse pancreatic enlargement with a characteristic sausage-shaped appearance and Balthazar grade E acute pancreatitis. The recurrence of pancreatitis, together with the characteristic imaging findings, prompted suspicion of type 1 AIP. Serum IgG4 levels were subsequently found to be elevated (240 mg/dL), further supporting the diagnosis in accordance with the International Consensus Diagnostic Criteria. The patient was treated with aggressive intravenous fluid resuscitation, continuous intravenous insulin infusion, and early corticosteroid therapy, resulting in rapid clinical improvement and normalization of metabolic abnormalities within 72 hours. This case…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- eggNOG 5.0: a hierarchical, functionally and phylogenetically annotated orthology resource based on 5090 organisms and 2502 viruses
- Online Survival Analysis Software to Assess the Prognostic Value of Biomarkers Using Transcriptomic Data in Non-Small-Cell Lung Cancer
- OptiType: precision HLA typing from next-generation sequencing data
- Nicotinic Cholinergic System and COVID-19: In Silico Identification of an Interaction between SARS-CoV-2 and Nicotinic Receptors with Potential Therapeutic Targeting Implications
- Saccharomyces cerevisiae cells have three Omega class glutathione S-transferases acting as 1-Cys thiol transferases
- Hemolysis at low blood flow rates: in-vitro and in-silico evaluation of a centrifugal blood pump
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.