Eruptive xanthomas in a patient with soft-drink diabetic ketosis and apolipoprotein E4/2.

Eruptive xanthomas in a patient with soft-drink diabetic ketosis and apolipoprotein E4/2. Endocr J. 2018 Nov 02;: Authors: Tsuchiya S, Sawada S, Takeda K, Takahashi K, Nakajima T, Kohata M, Kurosawa S, Satake C, Imai J, Kikuchi K, Aiba S, Katagiri H Abstract Soft-drink diabetic ketosis, characterized by acute onset ketosis induced by excessive ingestion of sugar-containing drinks, is often seen in obese, young patients, even with undiagnosed type 2 diabetes. We herein report a 15-year-old obese patient with the apolipoprotein E4/2 phenotype, in whom eruptive xanthomas lead to a diagnosis of soft-drink diabetic ketosis. He developed multiple asymptomatic yellowish papules on the auricles, back, buttocks and the extensor surfaces of the elbows and knees. He initially visited a dermatology clinic and his blood triglyceride and HbA1c levels were found to be 6,490 mg/dL and 16.5%, respectively. He was referred to our hospital for treatment of hyperglycemia and hypertyriglyceridemia. On admission, he had ketonuria and increased blood levels of 3-hydroxybutylate and acetoacetate. He habitually drank 1-3 litters of sweet beverages daily to quench his thirst. Therefore, "soft-drink diabetic ketosis" was diagnosed. Severe hypertriglyceridemia was considered to have been a consequence of impaired insulin action and his apolipoprotein E4/2 phenotype. We treated the diabetic ketosis and hypertriglyceridemia with intensive insulin therapy and a fa...
Source: Endocrine Journal - Category: Endocrinology Tags: Endocr J Source Type: research