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Recurrent Concurrent Diabetic Ketoacidosis and Thyroid Storm.

David F Crudo¹, Elizabeth T Walsh¹, Janel D Hunter¹

¹Pediatric Endocrinology, Wake Forest University School of Medicine, Winston-Salem, USA.

|May 7, 2021

Summary

Diabetic ketoacidosis and thyroid storm are rare, serious complications that can occur together. This case study details an adolescent with both conditions occurring concurrently twice.

Keywords:

autoimmune thyroid disease diabetic ketoacidosis thyroid storm thyrotoxicosis

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Area of Science:

Endocrinology
Metabolic Disorders
Thyroid Disorders

Background:

Diabetic ketoacidosis (DKA) and thyroid storm are critical endocrine emergencies.
These conditions can precipitate each other, though their co-occurrence is rare.
Patients with pre-existing diabetes or thyroid disease are susceptible to this dual presentation.

Observation:

A case of an adolescent with type 1 diabetes and autoimmune hypothyroidism is presented.
The patient experienced recurrent, concurrent DKA and thyroid storm twice within eight months.
This highlights an uncommon but serious clinical scenario.

Findings:

The simultaneous occurrence of DKA and thyroid storm is infrequent, with only 28 prior reported cases.
The pathophysiology linking DKA and thyroid storm is complex and bidirectional.
Concurrent DKA and thyroid storm necessitate prompt recognition and management.

Implications:

Understanding the interplay between DKA and thyroid storm is crucial for managing patients with coexisting diabetes and thyroid disease.
This case underscores the importance of considering both conditions in susceptible patients.
Further research into the pathophysiology may improve treatment strategies for these dual emergencies.