BioMedica |

Case Report

Volume: 41 | Issue: 2 | Published: Jun 25, 2025 | Pages: 16 - 16 | DOI: 10.24911/BioMedica/5-1634

Diabetic ketoacidosis in a thalassemia major patient with secondary hemochromatosis

Authors: Akhtar Ali , Muneeb Ur Rehman , Waseem Ullah , Sami Ullah

Authors

Akhtar Ali

Postgraduate Resident, Department of Emergency Medicine, Lady Reading Hospital/ Medical Teaching Institute, Peshawar, Pakistan

Muneeb Ur Rehman

Postgraduate Resident, Department of Surgical C Ward, Lady Reading Hospital/ Medical Teaching Institute, Peshawar, Pakistan

Waseem Ullah

Postgraduate Resident, Department of Surgical C Ward, Lady Reading Hospital/ Medical Teaching Institute, Peshawar, Pakistan

ORCID

Sami Ullah

Postgraduate Resident, Department of Pediatrics, Lady Reading Hospital/ Medical Teaching Institute, Peshawar, Pakistan

Publication History

Received: February 11, 2025

Accepted: June 06, 2025

Published: June 25, 2025

Abstract

Background: Diabetic ketoacidosis (DKA) is a life-threatening acute hyperglycemic complication of diabetes mellitus. Thalassemia major predisposes to diabetes mellitus due to pancreatic dysfunction from iron overload, yet DKA is uncommon in these patients. We report the case of an 18-year-old female with thalassemia major and secondary hemochromatosis who presented with acute shortness of breath, drowsiness, and confusion following one day of diarrhea. On examination, she was profoundly hypotensive (BP 54/21 mmHg), tachycardic (PR 131 bpm), hypoxic (SpO₂ 89%), and exhibited acidotic breathing, pallor, bronze skin pigmentation, and cold extremities. Laboratory evaluation revealed severe anemia, marked leukocytosis (>30,000/mm³), metabolic acidosis with hypokalemia, hyperglycemia, and markedly elevated ferritin (>1,650 ng/l). The patient was treated with insulin infusion, electrolyte correction, blood transfusion, iron chelation therapy, and supportive measures. She improved clinically, achieved metabolic stabilization, and was discharged in stable condition. This case underscores that thalassemia-related iron overload can precipitate disturbances in glucose metabolism and rarely present with DKA. Continuous monitoring of glycemic status is essential in thalassemia patients, even when baseline glucose levels are normal, to enable early detection and management of acute metabolic complications.

Keywords: Diabetic ketoacidosis, thalassemia Major, secondary hemochromatosis, iron chelation therapy.

Pubmed Style

Akhtar Ali, Muneeb Ur Rehman, Waseem Ullah, Sami Ullah. Diabetic ketoacidosis in a thalassemia major patient with secondary hemochromatosis. BioMedica. 2025; 25 (June 2025): 16-16. doi:10.24911/BioMedica/5-1634

Web Style

Akhtar Ali, Muneeb Ur Rehman, Waseem Ullah, Sami Ullah. Diabetic ketoacidosis in a thalassemia major patient with secondary hemochromatosis. https://biomedicapk.com/articles/1634 [Access: August 28, 2025]. doi:10.24911/BioMedica/5-1634

AMA (American Medical Association) Style

Vancouver/ICMJE Style

Akhtar Ali, Muneeb Ur Rehman, Waseem Ullah, Sami Ullah. Diabetic ketoacidosis in a thalassemia major patient with secondary hemochromatosis. BioMedica. (2025), [cited August 28, 2025]; 25 (June 2025): 16-16. doi:10.24911/BioMedica/5-1634

Harvard Style

Akhtar Ali, Muneeb Ur Rehman, Waseem Ullah, Sami Ullah (2025) Diabetic ketoacidosis in a thalassemia major patient with secondary hemochromatosis. BioMedica, 25 (June 2025): 16-16. doi:10.24911/BioMedica/5-1634

Chicago Style

Akhtar Ali, Muneeb Ur Rehman, Waseem Ullah, Sami Ullah. "Diabetic ketoacidosis in a thalassemia major patient with secondary hemochromatosis." 25 (2025), 16-16. doi:10.24911/BioMedica/5-1634

MLA (The Modern Language Association) Style

Akhtar Ali, Muneeb Ur Rehman, Waseem Ullah, Sami Ullah. "Diabetic ketoacidosis in a thalassemia major patient with secondary hemochromatosis." 25.June 2025 (2025), 16-16. Print. doi:10.24911/BioMedica/5-1634

APA (American Psychological Association) Style

Akhtar Ali, Muneeb Ur Rehman, Waseem Ullah, Sami Ullah (2025) Diabetic ketoacidosis in a thalassemia major patient with secondary hemochromatosis. , 25 (June 2025), 16-16. doi:10.24911/BioMedica/5-1634