Metabolic alkalosis masked presentation of diabetic ketoacidosis: A case report
Key Clinical Message Managing mixed acid–base disorders can be diagnostically challenging, particularly when metabolic acidosis and metabolic alkalosis occur simultaneously. When dealing with metabolic alkalosis, a comprehensive approach involves taking a detailed medical history, assessing volume s...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-12-01
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| Series: | Clinical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ccr3.8250 |
| _version_ | 1797372122253754368 |
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| author | Thunyatorn Wuttiputhanun Natavudh Townamchai Somchai Eiam‐Ong Kullaya Takkavatakarn |
| author_facet | Thunyatorn Wuttiputhanun Natavudh Townamchai Somchai Eiam‐Ong Kullaya Takkavatakarn |
| author_sort | Thunyatorn Wuttiputhanun |
| collection | DOAJ |
| description | Key Clinical Message Managing mixed acid–base disorders can be diagnostically challenging, particularly when metabolic acidosis and metabolic alkalosis occur simultaneously. When dealing with metabolic alkalosis, a comprehensive approach involves taking a detailed medical history, assessing volume status, and performing urine chloride analysis. Routine calculation of the anion gap is important to identify masked wide anion gap metabolic acidosis. We report a case of a 32‐year‐old female with type 1 diabetes mellitus, presented with intractable vomiting for 2 days with hyperglycemia, hypokalemia, and metabolic alkalosis, along with a wide anion gap. She was diagnosed with “diabetic ketoalkalosis” due to diabetic ketoacidosis combined with vomiting‐induced metabolic alkalosis. She became clinically stable after resuscitation with normal saline, intravenous potassium, and intravenous insulin. |
| first_indexed | 2024-03-08T18:30:19Z |
| format | Article |
| id | doaj.art-01ded45cf29e470e93f38deea5c83b24 |
| institution | Directory Open Access Journal |
| issn | 2050-0904 |
| language | English |
| last_indexed | 2024-03-08T18:30:19Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj.art-01ded45cf29e470e93f38deea5c83b242023-12-30T04:35:08ZengWileyClinical Case Reports2050-09042023-12-011112n/an/a10.1002/ccr3.8250Metabolic alkalosis masked presentation of diabetic ketoacidosis: A case reportThunyatorn Wuttiputhanun0Natavudh Townamchai1Somchai Eiam‐Ong2Kullaya Takkavatakarn3Division of Nephrology, Department of Medicine King Chulalongkorn Memorial Hospital and Chulalongkorn University Bangkok ThailandDivision of Nephrology, Department of Medicine King Chulalongkorn Memorial Hospital and Chulalongkorn University Bangkok ThailandDivision of Nephrology, Department of Medicine King Chulalongkorn Memorial Hospital and Chulalongkorn University Bangkok ThailandDivision of Nephrology, Department of Medicine King Chulalongkorn Memorial Hospital and Chulalongkorn University Bangkok ThailandKey Clinical Message Managing mixed acid–base disorders can be diagnostically challenging, particularly when metabolic acidosis and metabolic alkalosis occur simultaneously. When dealing with metabolic alkalosis, a comprehensive approach involves taking a detailed medical history, assessing volume status, and performing urine chloride analysis. Routine calculation of the anion gap is important to identify masked wide anion gap metabolic acidosis. We report a case of a 32‐year‐old female with type 1 diabetes mellitus, presented with intractable vomiting for 2 days with hyperglycemia, hypokalemia, and metabolic alkalosis, along with a wide anion gap. She was diagnosed with “diabetic ketoalkalosis” due to diabetic ketoacidosis combined with vomiting‐induced metabolic alkalosis. She became clinically stable after resuscitation with normal saline, intravenous potassium, and intravenous insulin.https://doi.org/10.1002/ccr3.8250diabetic ketoacidosisgastric alkalosisketoalkalosismetabolic alkalosis |
| spellingShingle | Thunyatorn Wuttiputhanun Natavudh Townamchai Somchai Eiam‐Ong Kullaya Takkavatakarn Metabolic alkalosis masked presentation of diabetic ketoacidosis: A case report Clinical Case Reports diabetic ketoacidosis gastric alkalosis ketoalkalosis metabolic alkalosis |
| title | Metabolic alkalosis masked presentation of diabetic ketoacidosis: A case report |
| title_full | Metabolic alkalosis masked presentation of diabetic ketoacidosis: A case report |
| title_fullStr | Metabolic alkalosis masked presentation of diabetic ketoacidosis: A case report |
| title_full_unstemmed | Metabolic alkalosis masked presentation of diabetic ketoacidosis: A case report |
| title_short | Metabolic alkalosis masked presentation of diabetic ketoacidosis: A case report |
| title_sort | metabolic alkalosis masked presentation of diabetic ketoacidosis a case report |
| topic | diabetic ketoacidosis gastric alkalosis ketoalkalosis metabolic alkalosis |
| url | https://doi.org/10.1002/ccr3.8250 |
| work_keys_str_mv | AT thunyatornwuttiputhanun metabolicalkalosismaskedpresentationofdiabeticketoacidosisacasereport AT natavudhtownamchai metabolicalkalosismaskedpresentationofdiabeticketoacidosisacasereport AT somchaieiamong metabolicalkalosismaskedpresentationofdiabeticketoacidosisacasereport AT kullayatakkavatakarn metabolicalkalosismaskedpresentationofdiabeticketoacidosisacasereport |