Diabetic Ketoacidosis as First Presentation of Latent Autoimmune Diabetes in AdultReport as inadecuate




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Case Reports in Medicine - Volume 2015 2015, Article ID 821397, 3 pages -

Case ReportInternal Medicine Department, Texas Tech University Health Sciences Center, Amarillo, TX 79106, USA

Received 4 May 2014; Revised 19 February 2015; Accepted 24 February 2015

Academic Editor: Christos D. Lionis

Copyright © 2015 Omar Nadhem et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 54-year-old white female with hypothyroidism presented with abdominal pain, nausea, vomiting, and diarrhea. She was found to have diabetic ketoacidosis DKA and admitted to our hospital for treatment. Laboratory workup revealed positive antiglutamic acid decarboxylase antibodies and subsequently she was diagnosed with latent onset autoimmune diabetes in adult LADA. She was successfully treated with insulin with clinical and laboratory improvement. Diagnosis of LADA has been based on three criteria as given by The Immunology of Diabetes Society: 1 adult age of onset >30 years of age; 2 presence of at least one circulating autoantibody GADA-ICA-IAA-IA-2; and 3 initial insulin independence for the first six months. The importance of this case is the unlikely presentation of LADA. We believe that more research is needed to determine the exact proportion of LADA patients who first present with DKA, since similar cases have only been seen in case reports. Adult patients who are obese and have high blood sugar may deserve screening for LADA, especially in the presence of other autoimmune diseases. Those patients once diagnosed with LADA need extensive diabetic education including potentially serious events such as diabetic ketoacidosis.





Author: Omar Nadhem, Essam Nakhla, and Roger D. Smalligan

Source: https://www.hindawi.com/



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