Empagliflozin-associated postoperative mixed metabolic acidosis. Case report and review of pathogenesis

Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00159816%3A_____%2F23%3A00079608" target="_blank" >RIV/00159816:_____/23:00079608 - isvavai.cz</a>
Alternative codes found
RIV/00216224:14110/23:00133368
Result on the web
<a href="https://bmcendocrdisord.biomedcentral.com/articles/10.1186/s12902-023-01339-w" target="_blank" >https://bmcendocrdisord.biomedcentral.com/articles/10.1186/s12902-023-01339-w</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1186/s12902-023-01339-w" target="_blank" >10.1186/s12902-023-01339-w</a>

Result language
angličtina
Original language name
Empagliflozin-associated postoperative mixed metabolic acidosis. Case report and review of pathogenesis
Original language description
BackgroundEuglycemic diabetic ketoacidosis associated with SGLT2 inhibitors is a rare, relatively new and potentially fatal clinical entity, characterized by metabolic acidosis with normal or only moderately elevated glycemia. The mechanisms are not fully understood but involve increased ketogenesis and complex renal metabolic dysfunction, resulting in both ketoacidosis and hyperchloremic acidosis. We report a rare case of fatal empagliflozin-associated acidosis with profound hyperchloremia and review its pathogenesis.Case presentationA patient with type 2 diabetes mellitus treated with empagliflozin underwent an elective hip replacement surgery. Since day 4 after surgery, he felt generally unwell, leading to cardiac arrest on the day 5. Empagliflozin-associated euglycemic diabetic ketoacidosis with severe hyperchloremic acidosis was identified as the cause of the cardiac arrest.ConclusionsThis unique case documents the possibility of severe SGLT2 inhibitor-associated mixed metabolic acidosis with a predominant hyperchloremic component. Awareness of this possibility and a high index of suspicion are crucial for correct and early diagnosis.
Czech name
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Czech description
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Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30202 - Endocrinology and metabolism (including diabetes, hormones)

Project
<a href="/en/project/EF16_019%2F0000868" target="_blank" >EF16_019/0000868: Molecular, cellular and clinical approach to healthy ageing</a><br>
Continuities
P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Publication year
2023
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

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