Severe hypertriglyceridemia causing acute pancreatitis in a child with new onset type I diabetes mellitus presenting in ketoacidosis

Article type: Research Article

Authors: Wolfgram, Peter M. | MacDonald, Michael J.

Affiliations: Division of Pediatric Diabetes and Endocrinology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

Note: [] Corresponding author: Peter M. Wolfgram, Division of Pediatric Diabetes and Endocrinology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792 USA. Tel.: +1 608 263 9059; Fax: +1 608 265 7957; E-mail: [email protected].

Abstract: A 10-year-old girl presented with severe diabetic ketoacidosis and a hemoglobin A1c of 17.9%. On hospital day 2, after acidosis had improved, it worsened and she developed excruciating abdominal pain. Her serum triglycerides and lipase levels were found to be extremely high and ultrasound analysis of the pancreas was consistent with acute pancreatitis. She was diagnosed with acute pancreatitis secondary to hypertriglyceridemia. The pancreatitis resolved completely and 2 mo later her hemoglobin A1c was 8.2% and the serum triglycerides were normal. Severe hypertriglyceridemia from insulin deficiency causing pancreatitis in new onset type 1 diabetes mellitus is a rare but serious complication of diabetic ketoacidosis in children.

Keywords: Type 1 diabetes mellitus, diabetic ketoacidosis, pancreatitis, hypertriglyceridemia, autoimmune diabetes

DOI: 10.3233/PIC-13053

Journal: Journal of Pediatric Intensive Care, vol. 2, no. 2, pp. 77-80, 2013