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Published on: April 25, 2014
Splenic Infarction with Myocardial Injury in a Diabetic Patient: A Case Report
Congcong Wang1, Song Wen1, Ligang Zhou1,2
1Department of Endocrinology, Shanghai Pudong Hospital, Fudan University, Shanghai, 201399, People's Republic of China.
Insights
Splenic infarction is a rare diabetes complication. This case highlights how diabetes increases thrombotic risks, potentially causing multiple organ infarctions that may be overlooked.
Area of Science:
- Internal Medicine
- Cardiology
- Endocrinology
Background:
- Type 2 diabetes (T2D) is linked to vascular abnormalities, increasing risks of atherosclerosis and thrombosis.
- Splenic infarction (SI) is an uncommon but serious complication in diabetic patients.
- Co-existing conditions like pneumonia or cardiac events can mask SI diagnosis.
Observation:
- An 80-year-old female with T2D and chronic bronchitis presented with symptoms suggestive of multiple acute conditions.
- She exhibited atrial fibrillation, elevated cardiac biomarkers (troponin I), and increased amylase, indicating potential acute myocardial infarction and pancreatitis.
- Abdominal CT revealed splenic artery calcification and splenic lesions.
Findings:
- The patient was diagnosed with splenic infarction (SI) secondary to thrombotic complications.
- Her presentation underscored the increased risk of simultaneous vascular thrombotic events in multiple organs in T2D.
- High white blood cell count and splenic embolism were noted.
Implications:
- Clinicians must consider SI in diabetic patients presenting with multiple acute vascular events.
- Early recognition of SI is crucial for timely intervention and improved patient outcomes.
- This case emphasizes the systemic thrombotic risks associated with T2D, necessitating comprehensive vascular assessment.
Abstract:
Splenic infarction (SI) is an uncommon complication of type 2 diabetes (T2D). Diabetes predisposes individuals to blood vessel abnormalities, such as atherosclerosis or thrombosis, increasing the risk of vessel occlusion and subsequent tissue infarction. If the diabetic patient has other serious diseases, such as a severe pneumonia infection and acute cardiac infarction, SI incidence may go unrecognized, making it challenging for physicians to identify. This case report discussed an 80-year-old hospitalized diabetic woman with a history of chronic bronchitis and 20 years of T2D who suffered an SI. The patient was at elevated risk for thrombosis of atrial fibrillation, manifested as an embolism of the spleen characterized by a high concentration of white blood cells. This patient also demonstrated a rapid increase in cardiac biomarkers troponin I, suggesting acute myocardial infarction (AMI) and increased amylase, which could not preclude the concern about the existence of acute pancreatitis. Abdominal CT displayed the calcification of only the splenic and other arteries, and low-density shadows were observed at the center portion of the spleen. This case demonstrated the significant occurrence of thrombotic complications in various blood vessels of multiple organs in T2D patients. Thus, clinicians should be aware of the possibility of simultaneous acute vascular infarction of several organs in diabetic patients with prior vascular constriction.
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