Key result
Acute-phase DKA treatment linked to massive DVT and PE in partial protein C deficiency.
Why the study?
Venous thrombosis is a potential complication of DKA, especially in patients with partial protein C deficiency, but its clinical management is not well established.
Case Report (n=1)
Venous thrombosis should be considered a potential complication of DKA, especially in patients with protein C deficiency undergoing central venous catheterization.
May signal post-DKA VTE risk in protein C deficiency; leaves open whether prophylaxis is warranted.
A 25-year-old man was diagnosed with diabetic ketoacidosis (DKA) at the onset of fulminant type 1 diabetes. After acute-phase DKA treatment including placement of a central venous catheter, a massive deep vein thrombosis (DVT) and pulmonary embolism (PE) were detected on hospital day 15. His protein C (PC) activity and antigen levels were low even 33 days after completing the DKA treatment, indicating partial type I PC deficiency. Severe PC dysfunction, due to overlapping of partial PC deficiency and hyperglycemia-induced PC suppression, concomitant with dehydration and catheter treatment, may have induced the massive DVT with PE. This case suggests that anti-coagulation therapy should be combined with acute-phase DKA treatment in patients with PC deficiency, even those who have been asymptomatic. As patients with partial PC deficiency should perhaps be included among those with severe DVT complications of DKA, venous thrombosis should always be considered as a potential complication of DKA.
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Kohata et al. (2023) conducted a case report in Fulminant type 1 diabetes, diabetic ketoacidosis, protein C deficiency (n=1). Protein C deficiency and DKA treatment with central venous catheter was evaluated on Deep vein thrombosis and pulmonary embolism. A 25-year-old man with partial protein C deficiency developed massive deep vein thrombosis and pulmonary embolism following acute-phase treatment for diabetic ketoacidosis.
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