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
Article Info
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
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 08, 2025]. doi:10.24911/BioMedica/5-1634
AMA (American Medical Association) 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
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 08, 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