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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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