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@article{2368532,
author = {Šitina, Michal and Lukeš, Marek and Šrámek, Vladimír},
article_location = {LONDON},
article_number = {1},
doi = {http://dx.doi.org/10.1186/s12902-023-01339-w},
keywords = {Empagliflozin; SGLT2 inhibitor; Euglycemic ketoacidosis; Hyperchloremic acidosis; Case report},
language = {eng},
issn = {1472-6823},
journal = {BMC ENDOCRINE DISORDERS},
title = {Empagliflozin-associated postoperative mixed metabolic acidosis. Case report and review of pathogenesis},
url = {https://bmcendocrdisord.biomedcentral.com/articles/10.1186/s12902-023-01339-w},
volume = {23},
year = {2023}
}
TY - JOUR
ID - 2368532
AU - Šitina, Michal - Lukeš, Marek - Šrámek, Vladimír
PY - 2023
TI - Empagliflozin-associated postoperative mixed metabolic acidosis. Case report and review of pathogenesis
JF - BMC ENDOCRINE DISORDERS
VL - 23
IS - 1
SP - 1-6
EP - 1-6
PB - BMC
SN - 14726823
KW - Empagliflozin
KW - SGLT2 inhibitor
KW - Euglycemic ketoacidosis
KW - Hyperchloremic acidosis
KW - Case report
UR - https://bmcendocrdisord.biomedcentral.com/articles/10.1186/s12902-023-01339-w
N2 - BackgroundEuglycemic diabetic ketoacidosis associated with SGLT2 inhibitors is a rare, relatively new and potentially fatal clinical entity, characterized by metabolic acidosis with normal or only moderately elevated glycemia. The mechanisms are not fully understood but involve increased ketogenesis and complex renal metabolic dysfunction, resulting in both ketoacidosis and hyperchloremic acidosis. We report a rare case of fatal empagliflozin-associated acidosis with profound hyperchloremia and review its pathogenesis.Case presentationA patient with type 2 diabetes mellitus treated with empagliflozin underwent an elective hip replacement surgery. Since day 4 after surgery, he felt generally unwell, leading to cardiac arrest on the day 5. Empagliflozin-associated euglycemic diabetic ketoacidosis with severe hyperchloremic acidosis was identified as the cause of the cardiac arrest.ConclusionsThis unique case documents the possibility of severe SGLT2 inhibitor-associated mixed metabolic acidosis with a predominant hyperchloremic component. Awareness of this possibility and a high index of suspicion are crucial for correct and early diagnosis.
ER -
ŠITINA, Michal, Marek LUKEŠ a Vladimír ŠRÁMEK. Empagliflozin-associated postoperative mixed metabolic acidosis. Case report and review of pathogenesis. \textit{BMC ENDOCRINE DISORDERS}. LONDON: BMC, 2023, roč.~23, č.~1, s.~1-6. ISSN~1472-6823. Dostupné z: https://dx.doi.org/10.1186/s12902-023-01339-w.
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