Key result
DKA treatment rapidly resolves severe hypercalcemia and pseudo-STEMI ECG changes.
Why the study?
Hypercalcemia is a rare electrolyte derangement in diabetic ketoacidosis, especially in the absence of severe acidosis, and its clinical presentation can mimic STEMI.
Case Report (n=1)
Diabetic ketoacidosis with severe hypercalcemia can present as a rare STEMI mimic that resolves with standard DKA treatment.
Hypercalcemia may occur in DKA without severe acidosis; leaves open whether calcium monitoring should be routine in management.
Diabetic ketoacidosis (DKA) is a common complication in patients with type I and ketosis-prone type II diabetes mellitus. A variety of electrolyte derangements are encountered during the presentation and management of DKA. Hypercalcemia has been rarely reported in DKA, particularly when patients develop severe acidosis. However, we describe a patient with DKA and severe hypercalcemia in the absence of severe acidosis. The hypercalcemia quickly corrected back to normal with the treatment of DKA.
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Ahmed et al. (2020) conducted a case report in Diabetic Ketoacidosis with Severe Hypercalcemia (n=1). Intravenous fluids and insulin drip was evaluated on Resolution of hypercalcemia and ECG changes. Treatment of diabetic ketoacidosis with intravenous fluids and insulin rapidly normalized severe hypercalcemia and resolved the ST-segment elevations mimicking a myocardial infarction.
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