Empagliflozin-associated postoperative mixed metabolic
acidosis. Case report and review of pathogenesis

J 2023

Empagliflozin-associated postoperative mixed metabolic acidosis. Case report and review of pathogenesis

ŠITINA, Michal, Marek LUKEŠ a Vladimír ŠRÁMEK

Základní údaje

Originální název

Empagliflozin-associated postoperative mixed metabolic acidosis. Case report and review of pathogenesis

Autoři

ŠITINA, Michal (203 Česká republika, garant, domácí), Marek LUKEŠ (203 Česká republika, domácí) a Vladimír ŠRÁMEK (203 Česká republika, domácí)

Vydání

BMC ENDOCRINE DISORDERS, LONDON, BMC, 2023, 1472-6823

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30202 Endocrinology and metabolism

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.700 v roce 2022

Kód RIV

RIV/00216224:14110/23:00133368

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1186/s12902-023-01339-w

UT WoS

000971725600002

Klíčová slova anglicky

Empagliflozin; SGLT2 inhibitor; Euglycemic ketoacidosis; Hyperchloremic acidosis; Case report

Štítky

14110122, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 1. 2. 2024 10:14, Mgr. Tereza Miškechová

Anotace

V originále

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.

Citovat

ŠITINA, Michal, Marek LUKEŠ a Vladimír ŠRÁMEK. Empagliflozin-associated postoperative mixed metabolic acidosis. Case report and review of pathogenesis. 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.

@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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