급성으로 갑상선 위기와 당뇨병성 케톤산증이 동시에 발현한 증례 1예

Two important endocrine emergencies, thyroid crisis and diabetic ketoacidosis (DKA), are uncommon when presented together, but pose serious complications, without appropriate management, they may result in high mortality. Although several cases of simultaneous presentation of thyroid crisis and DKA have been reported, it is a clinically unusual situation and remains a diagnostic and management challenge in clinical practice. We report rare case with simultaneous presentation of thyroid crisis and DKA without previous warning symptoms. A 23-year-old-woman was brought to the emergency department presenting with acute abdominal pain for one day. She was healthy and there was no personal history of diabetes or thyroid disease. Through careful physical examination and laboratory tests, the patient was diagnosed with thyroid crisis combined with DKA. Concomitance of these two endocrine emergencies led to sudden cardiac arrest, but she was successfully resuscitated. This emphasizes the importance of early recognition and prompt management when the two diseases are presented concomitantly. (Endocrinol Metab 27:63-67, 2012)