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A case of myocarditis associated with IDDM
1Department of Internal Medicine, Fujita Health University School of Medicine, Aichi, Japan.
Abstract:
We report a case of diabetic ketoacidosis (DKA) complicated by acute myocarditis, which was confirmed by cardiac biopsy. A 26-year-old man was hospitalized with severe DKA. On admission, nonspecific ST-T change was noted on the electrocardiogram (ECG). The patient's levels of creatine phosphokinase (CPK) and glutamic oxaloacetic transaminase were slightly elevated, but he did not complain of chest discomfort or symptoms of heart disease. On the first day after admission, ST-T elevation was noted on ECG during treatment of DKA. By cardiac angiography and cardiac biopsy, coronary heart disease was ruled out and postmyocarditic change was histologically confirmed. An episode of upper respiratory viral infection before the onset of acute diabetes suggested that the patient suffered from viral-induced myocarditis and consequent development of IDDM. This possibility was confirmed by the clinical course of ECG change, with elevated CPK and lactate dehydrogenase and a slightly elevated antibody titer for echovirus.
Insights
Diabetic ketoacidosis (DKA) can complicate with acute myocarditis. This case highlights viral-induced myocarditis leading to DKA and IDDM, confirmed by cardiac biopsy and ECG changes.
Area of Science:
- Cardiology
- Endocrinology
- Infectious Disease
Background:
- Diabetic ketoacidosis (DKA) is a serious complication of diabetes.
- Myocarditis, inflammation of the heart muscle, can have various causes and presentations.
- The interplay between DKA, myocarditis, and viral infections requires further understanding.