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Profound hyperlipidaemia due to concomitant diabetes and hypothyroidism
M Constantine Samaan1, Nuala Murphy, Colm Costigan
1Our Lady's Children's Hospital Crumlin, Division of Endocrinology, Dublin 12, Ireland.
BMJ Case Reports
|March 6, 2012
Summary
A young girl with new-onset type 1 diabetes and diabetic ketoacidosis also had hypothyroidism and severe hyperlipidemia. Treatment with insulin and L-thyroxine normalized lipids, but deep vein thrombosis occurred.
Area of Science:
- Pediatrics
- Endocrinology
- Metabolic Disorders
Background:
- Type 1 diabetes mellitus (T1DM) can present with complex metabolic disturbances.
- Hyperlipidemia is a known complication of uncontrolled diabetes and hypothyroidism.
- Co-occurrence of these conditions in children requires careful evaluation and management.
Purpose of the Study:
- To report a case of a 5-year-old girl with new-onset T1DM, diabetic ketoacidosis, severe hyperlipidemia, and hypothyroidism.
- To discuss the diagnostic challenges and management strategies for this rare combination of conditions.
- To emphasize the importance of lipid profiling in patients with concurrent diabetes and hypothyroidism.
Main Methods:
- Case report of a 5-year-old female patient.
- Clinical presentation, laboratory investigations (including lipid profile, thyroid function tests), and diagnostic workup.
- Treatment with insulin, L-thyroxine, and anticoagulation.
- Follow-up of clinical status and lipid profile.
Main Results:
- The patient presented with new-onset T1DM, diabetic ketoacidosis, and profound hyperlipidemia.
- Associated hypothyroidism was diagnosed.
- Lipid profile normalized within 2 months of treatment with insulin and L-thyroxine.
- Despite early anticoagulation, the patient developed deep vein thrombosis.
- Family screening did not reveal familial hyperlipidemia or hypothyroidism.
Conclusions:
- Concomitant T1DM and hypothyroidism can lead to severe hyperlipidemia in children.
- Early diagnosis and treatment of both endocrine disorders are crucial for metabolic control.
- Vigilant monitoring for complications such as venous thromboembolism is warranted.
- Screening for hyperlipidemia in children with coexisting diabetes and hypothyroidism is recommended.
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