A Case of Diabetic Ketoacidosis Presenting with Hypernatremia, Hyperosmolarity, and Altered Sensorium

Diabetic Ketoacidosis commonly presents with hyponatremia, but hypernatremia is a rare entity. We report a unique case of a 50-year-old woman admitted with altered sensorium with blood glucose 979 milligrams/deciliter, serum osmolarity 363 mOsm/kilograms, and serum sodium 144 milliequivalents/liter....

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Autores principales: Kumar, Vinod, Nanavati, Sushant M., Melki, Gabriel, Upadhyaya, Mira, Dhillon, Raman, Gibiezaite, Sandra, Michael, Patrick, Singhal, Monisha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6077649/
https://www.ncbi.nlm.nih.gov/pubmed/30112226
http://dx.doi.org/10.1155/2018/4806598
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author Kumar, Vinod
Nanavati, Sushant M.
Melki, Gabriel
Upadhyaya, Mira
Dhillon, Raman
Gibiezaite, Sandra
Michael, Patrick
Singhal, Monisha
author_facet Kumar, Vinod
Nanavati, Sushant M.
Melki, Gabriel
Upadhyaya, Mira
Dhillon, Raman
Gibiezaite, Sandra
Michael, Patrick
Singhal, Monisha
author_sort Kumar, Vinod
collection PubMed
description Diabetic Ketoacidosis commonly presents with hyponatremia, but hypernatremia is a rare entity. We report a unique case of a 50-year-old woman admitted with altered sensorium with blood glucose 979 milligrams/deciliter, serum osmolarity 363 mOsm/kilograms, and serum sodium 144 milliequivalents/liter. Patient was given initial bolus of isotonic saline and continued on half isotonic saline for correction of hypernatremia along with insulin infusion therapy. Patient was successfully treated with intravenous fluids, insulin infusion, and the altered sensorium was resolved without any sequelae. This case illustrates a teaching point in the use of intravenous fluids for the treatment of Diabetic Ketoacidosis with hypernatremia.
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spelling pubmed-60776492018-08-15 A Case of Diabetic Ketoacidosis Presenting with Hypernatremia, Hyperosmolarity, and Altered Sensorium Kumar, Vinod Nanavati, Sushant M. Melki, Gabriel Upadhyaya, Mira Dhillon, Raman Gibiezaite, Sandra Michael, Patrick Singhal, Monisha Case Rep Endocrinol Case Report Diabetic Ketoacidosis commonly presents with hyponatremia, but hypernatremia is a rare entity. We report a unique case of a 50-year-old woman admitted with altered sensorium with blood glucose 979 milligrams/deciliter, serum osmolarity 363 mOsm/kilograms, and serum sodium 144 milliequivalents/liter. Patient was given initial bolus of isotonic saline and continued on half isotonic saline for correction of hypernatremia along with insulin infusion therapy. Patient was successfully treated with intravenous fluids, insulin infusion, and the altered sensorium was resolved without any sequelae. This case illustrates a teaching point in the use of intravenous fluids for the treatment of Diabetic Ketoacidosis with hypernatremia. Hindawi 2018-07-16 /pmc/articles/PMC6077649/ /pubmed/30112226 http://dx.doi.org/10.1155/2018/4806598 Text en Copyright © 2018 Vinod Kumar et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Kumar, Vinod
Nanavati, Sushant M.
Melki, Gabriel
Upadhyaya, Mira
Dhillon, Raman
Gibiezaite, Sandra
Michael, Patrick
Singhal, Monisha
A Case of Diabetic Ketoacidosis Presenting with Hypernatremia, Hyperosmolarity, and Altered Sensorium
title A Case of Diabetic Ketoacidosis Presenting with Hypernatremia, Hyperosmolarity, and Altered Sensorium
title_full A Case of Diabetic Ketoacidosis Presenting with Hypernatremia, Hyperosmolarity, and Altered Sensorium
title_fullStr A Case of Diabetic Ketoacidosis Presenting with Hypernatremia, Hyperosmolarity, and Altered Sensorium
title_full_unstemmed A Case of Diabetic Ketoacidosis Presenting with Hypernatremia, Hyperosmolarity, and Altered Sensorium
title_short A Case of Diabetic Ketoacidosis Presenting with Hypernatremia, Hyperosmolarity, and Altered Sensorium
title_sort case of diabetic ketoacidosis presenting with hypernatremia, hyperosmolarity, and altered sensorium
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6077649/
https://www.ncbi.nlm.nih.gov/pubmed/30112226
http://dx.doi.org/10.1155/2018/4806598
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