Korean J Fam Med.  2024 Jan;45(1):51-55. 10.4082/kjfm.23.0230.

A Case of Acute Neurologic Deficit and Hypoglycemia in the Setting of Thyroid Storm and Diabetic Ketoacidosis: A New Clinical Scenario

• Aleksashina A
• Rachina S
• Kiyakbaev G
• Hewathanthirige G
• Cherdantseva Y

• KMID: 2550820
• DOI: http://doi.org/10.4082/kjfm.23.0230

Abstract

The simultaneous development of diabetic ketoacidosis (DKA) and thyroid storm (TS) is a rare but potentially lifethreatening condition that requires immediate and targeted treatment. However, their combined diagnosis poses a serious challenge because of the similarities between their clinical manifestations. To date, only a few dozen cases have been described; most of which have been linked to the progression of thyrotoxicosis or uncontrolled hyperglycemia as contributing factors. We present the case of a 37-year-old woman with type 1 diabetes mellitus and Graves’ disease who presented with both TS and DKA. She was initially admitted to the emergency department as a suspected case of stroke. Severe hypoglycemia significantly lowered her alertness to TS and probably provoked a sharp hyperthyroid decompensation, thereby leading to subsequent DKA development.

Keyword

Thyroid Storm; Diabetic Ketoacidosis; Hypoglycemia; Graves’ Disease; Type 1 Diabetes Mellitus; Burch-Wartofsky Point Scale; Case Report