Unbound MEDLINE

Metabolic acidosis in a patient with type 1 diabetes mellitus complicated by methanol and amitriptyline intoxication.

Abstract

Diabetic ketoacidosis (DKA) is a widely known acute metabolic complication of diabetes mellitus (DM), which can be potentially fatal. It is not difficult to diagnose when a patient with DM comes with symptoms such as coma, fruity breath, hyperglycemia, acidosis, and tachypnea. If the patient has not been diagnosed with DM before, then other sicknesses characterized by an increased anion gap should be considered. A 12-year-old boy with type 1 DM and repeated earlier admissions for DKA was admitted to the emergency department in another apparent case of DKA with coma, hyperglycemia, and profound metabolic acidosis. When his condition did not improve with initial treatment, intoxication was suspected as an alternate cause of his condition. Further laboratory tests detected methanol and amitriptyline. The patient underwent hemodialysis and recovered completely. This case illustrates that a seemingly obvious medical condition can mask serious intoxication. This report is the only publication on two different entities characterized by an increased anion gap and at the end the patient has been cured completely without any complications.

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  • Publisher Full Text
  • Authors

    Celik U, Celik T, Avci A, Annagur A, Yilmaz HL, Kucukosmanoglu O, Topaloglu AK, Daglioglu N

    Institution

    Department of Pediatrics, Division of Pediatric Infectious Disease, Cukurova University, Adana, Turkey. ucelik@cu.edu.tr

    Source

    European journal of emergency medicine : official journal of the European Society for Emergency Medicine 16:1 2009 Feb pg 45-8

    MeSH

    Amitriptyline
    Analgesics, Non-Narcotic
    Child
    Diabetes Mellitus, Type 1
    Diabetic Ketoacidosis
    Homeless Youth
    Humans
    Male
    Methanol
    Renal Dialysis
    Substance-Related Disorders

    Pub Type(s)

    Case Reports
    Journal Article

    Language

    eng

    PubMed ID

    19106720