A 13-year-old T1D patient presented to the ED with the complaints of severe abdominal pain and vomiting. He has T1D from the past five years and is taking four insulin injections per day. He was followed-up for adrenal insufficiency a year back and was treated with hydrocortisone 25 mg per day. Among his family members, his maternal uncle has T2DM and his sister has corticoid-induced diabetes. Physical examination : Weight: 44 Kg Height: 156 cm Pulse rate: 80/min Respiratory rate: 16/min BP: 90/61mmHg Laboratory examinations : He has a glycemic imbalance with a hemoglobin A1c level of 11.5%.
He was found to have DKA with a lipase level of 1000 U/L. An abdominal ultrasound suggested acute pancreatitis associated with a moderate peritoneal effusion. Abdominal CT revealed pancreatitis grade E with antropyloric parietal thickening extended to the second part of the duodenum. Plasma…
