Marzo 2016 - Volume XXXV - numero 3
Pagine elettroniche
1UOC di Pediatria e Neonatologia, Ospedale di Ravenna; 2Ospedale di Faenza; 3UOC di Pediatria e Neonatologia, Ospedale di Cesena, AUSL della Romagna
Indirizzo per corrispondenza: vanna.graziani@gmail.com
Key words: Coeliac disease, Diabetes, Ketoacidosis, Thyrotoxicosis
The paper describes the case of a teenager affected by type 1 diabetes mellitus and coeliac disease who presented secondary ketoacidosis (DKA) triggered by thyrotoxicosis. She was successfully treated with beta-blocker and methimazole, in addition to intravenous insulin therapy. The association of thyrotoxicosis and DKA is uncommon but anecdotal cases are reported in literature. Through different mechanisms hyperthyroidism may cause decreased levels of insulin and increased glycogenolysis, ketogenesis, dehydration, and insulin resistance. The possibility of DKA triggered by thyrotoxicosis should be kept in mind in female patient or in the presence of symptoms of hyperthyroidism.
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Pagine elettroniche
1SC di Pediatria d’Urgenza, 2SSVD di Endocrinologia e Diabetologia Pediatrica, AOU Città della Salute e della Scienza di Torino, Ospedale Infantile Regina Margherita, Torino
Indirizzo per corrispondenza: ecastagno@cittadellasalute.to.it
Key words: Addison’s disease, Primary adrenocortical failure, Hyperpigmentation, Hyponatraemia, Hypoglycaemia, Ketosis
Addison’s disease (primary adrenocortical failure) is a rare condition mainly of autoimmune origin. Signs and symptoms are usually mild and non-specific, as abdominal pain, failure to thrive, weight loss, anorexia, vomiting and diarrhoea associated to bronzed skin colour. The diagnosis is often delayed. The paper reports two cases of children in which the association between hyperpigmentation and dehydration with metabolic acidosis, hyponatraemia and hypoglycaemia not proportionate to concomitant vomiting led to the clinical suspect.
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