{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T03:23:43Z","timestamp":1761017023550,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>A 23-year-old woman with a history of type 2 diabetes and non-compliance presented to the emergency department with abdominal epigastric pain and nausea. Laboratory examination revealed a mild ketoacidosis while an abdominal CT scan performed the following day demonstrated a severe acute pancreatitis of the body and tail (Balthazar grade E) despite normal amylase serum levels on admission. The presence of a lactescent serum was the clue to an extremely high triglyceride level (&gt;10\u2005000\u2005mg\/dl) causing the pancreatitis. The hypertriglyceridaemia itself was attributed mainly to the diabetic ketoacidosis. There was no family history of hypertriglyceridaemia. The triad consisting of diabetic ketoacidosis, hypertriglyceridaemia and acute pancreatitis is an unusual presentation of poorly controlled diabetes which can occur in type 1 as well as type 2 diabetic adults and children. Treatment with intravenous insulin and hydration successfully resolved the ketoacidosis and hypertriglyceridaemia and reversed the episode of acute pancreatitis.<\/jats:p>","DOI":"10.1136\/bcr-2012-008455","type":"journal-article","created":{"date-parts":[[2013,4,30]],"date-time":"2013-04-30T01:10:53Z","timestamp":1367284253000},"page":"bcr2012008455","source":"Crossref","is-referenced-by-count":3,"title":["Poorly controlled type 2 diabetes complicated by an episode of severe hypertriglyceridaemia-induced pancreatitis"],"prefix":"10.1136","volume":"2013","author":[{"given":"Nathalie","family":"Denecker","sequence":"first","affiliation":[{"name":"Department of Endocrinology-Diabetes, UZ Brussel, Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katelijn","family":"Decochez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology-Diabetes, UZ Brussel, Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,4,29]]},"reference":[{"key":"2025082707474589000_2013.apr29_1.bcr2012008455.1","doi-asserted-by":"crossref","first-page":"3540","DOI":"10.1136\/bmj.e3540","article-title":"Consider ketosis prone type 2 diabetes as cause of ketoacidosis in adult patients","volume":"2013","author":"De Wolff","year":"2012","journal-title":"BMJ"},{"key":"2025082707474589000_2013.apr29_1.bcr2012008455.2","first-page":"67","article-title":"Ketoacidosis occurs in both type 1 and type 2 diabetes\u2014 a population-based study from Northern Sweden","volume":"2013","author":"Wang","year":"2008","journal-title":"Diabet Med"},{"key":"2025082707474589000_2013.apr29_1.bcr2012008455.3","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1210\/er.2007-0026","article-title":"Syndromes of ketosis-prone diabetes mellitus","volume":"2013","author":"Balasubramanyam","year":"2008","journal-title":"Endocr Rev"},{"key":"2025082707474589000_2013.apr29_1.bcr2012008455.4","doi-asserted-by":"crossref","first-page":"3123","DOI":"10.1111\/j.1572-0241.2000.03279.x","article-title":"Nonspecific hyperamylasemia and hyperlipasemia in diabetic ketoacidosis: incidence and correlation with biochemical abnormalities","volume":"2013","author":"Yadav","year":"2000","journal-title":"Am J Gastroenterol"},{"key":"2025082707474589000_2013.apr29_1.bcr2012008455.5","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1097\/00000658-197507000-00014","article-title":"Inhibition of serum and urine amylase activity in pancreatitis with hyperlipemia","volume":"2013","author":"Warshaw","year":"1975","journal-title":"Ann Surg"},{"key":"2025082707474589000_2013.apr29_1.bcr2012008455.6","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1542\/peds.2011-0217","article-title":"Plasmapheresis to treat hypertriglyceridemia in a child with diabetic ketoacidosis and pancreatitis","volume":"2013","author":"Lutfi","year":"2012","journal-title":"Pediatrics"},{"key":"2025082707474589000_2013.apr29_1.bcr2012008455.7","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1136\/archdischild-2012-301810","article-title":"Severe hyperlipidaemia complicating diabetic ketoacidosis","volume":"2013","author":"Williamson","year":"2012","journal-title":"Arch Dis Child"},{"key":"2025082707474589000_2013.apr29_1.bcr2012008455.8","first-page":"2134","article-title":"Clinical assessment of hyperlipidemic pancreatitis","volume":"2013","author":"Fortson","year":"1995","journal-title":"Am J Gastroenterol"},{"key":"2025082707474589000_2013.apr29_1.bcr2012008455.9","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1097\/00004836-200301000-00016","article-title":"Issues in hyperlipidemic pancreatitis","volume":"2013","author":"Yadav","year":"2003","journal-title":"J Clin Gastroenterol"},{"key":"2025082707474589000_2013.apr29_1.bcr2012008455.10","first-page":"249","article-title":"Chylomicronemia syndrome","volume":"2013","author":"Chait","year":"1992","journal-title":"Adv Intern Med"},{"key":"2025082707474589000_2013.apr29_1.bcr2012008455.11","doi-asserted-by":"crossref","first-page":"706","DOI":"10.2337\/diacare.3.6.706","article-title":"Diabetic lipemia in childhood diabetic ketoacidosis: a clue to coexisting acute pancreatitis","volume":"2013","author":"Winter","year":"1980","journal-title":"Diabetes Care"},{"key":"2025082707474589000_2013.apr29_1.bcr2012008455.12","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1097\/00000441-199012000-00004","article-title":"Severe hypertriglyceridemia in diabetic ketosis","volume":"2013","author":"Fulop","year":"1990","journal-title":"Am J Med Sci"},{"key":"2025082707474589000_2013.apr29_1.bcr2012008455.13","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/S1056-8727(01)00183-0","article-title":"Diabetic hypertriglyceridemia-induced acute pancreatitis masquerading as biliary pancreatitis","volume":"2013","author":"Huang","year":"2002","journal-title":"J Diabetes Complications"},{"key":"2025082707474589000_2013.apr29_1.bcr2012008455.14","first-page":"1560","article-title":"Diabetic ketoacidosis, hyperlipidemia, and acute pancreatitis: the enigmatic triangle","volume":"2013","author":"Nair","year":"1997","journal-title":"Am J Gastroenterol"},{"key":"2025082707474589000_2013.apr29_1.bcr2012008455.15","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.3346\/jkms.2010.25.9.1375","article-title":"Severe hypertriglyceridemia in diabetic ketoacidosis accompanied by acute pancreatitis: case report","volume":"2013","author":"Hahn","year":"2010","journal-title":"J Korean Med Sci"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2012-008455","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:47:56Z","timestamp":1756306076000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2012-008455"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,4,29]]},"references-count":15,"alternative-id":["10.1136\/bcr-2012-008455"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2012-008455","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2013,4,29]]}}}