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EBCR CASE:

Male, 26 years old, recurrent DKA, IDDM.

History

Hospital Stay Clinical Laboratory Findings Assessment Discharge


Findings Therapy
19/9/2016 – Dyspnea,  Leucocytosis 24,490/mm3  DKA  Humalog 3x10 U
24/9/2016 abdominal pain,  Thrombocytosis 478,200/ mm3  IDDM  Lantus 1x35 U
(6 days in ward) weakness  Blood glucose 642 mg/dL
 Blood ketone 2,1 mmol/L
 A1c 12.6%

3/8/2017 – Dyspnea  Leucocytosis  DKA  Humalog 3x15 U


8/8/2017  A1c 11.8%  IDDM  Lantus 1x10 U
(6 days in ward)
26/2/2018 – Loss of  Leucocytosis 49,540/mm3  Septic shock  Humalog 3x25 U
5/3/2018 consciousness  Potassium 7.1 mEq/L  DKA  Lantus 1x24 U
(2 days in ICU, 6  Blood glucose 1,432 mg/dL  IDDM
days in ward)  Ur 131 mg/dL  AKI
 Cr 3.26 mg/dL
 Chest x-ray: active pulmonary lesion
2/4/2018 – Loss of  Leucocytosis 29,040/mm3  DKA  Apidra 3x20 U
9/4/2018 consciousness,  Trombocytosis 487,000/ mm3  IDDM  Lantus 1x10 U
(3 days in ICU, 5 fever, sweating,  Blood glucose 872 mg/dL  Pulmonary TB
days in ward) coughing  BGA : pH 7.137; pCO2 14.7; pO2 139.8; HCO3 5.0
 Blood ketone 2.7
7/10/2018 – Dyspnea,  Leucocytosis 30,660/mm3  DKA  Humalog 3x14 U
13/10/2018 (7 in vomiting, fever  Trombocytosis 742,940/ mm3  IDDM  Lantus 1x32 U
ward)  Blood glucose 685 mg/dL  AKI
 Ur 38 mg/dL
 Cr 1.32 mg/dL
 BGA : pH 7.046; pCO2 16.3; pO2 82; SO2 89.9; BE
-26.2, HCO3 4,5