AI Summary & Key Takeaways
AI InsightThis case, with the presentation of massive pulmonary embolism, resulted from the synergistic effect of hyperhomocysteinemia associated with B12 deficiency; hypovolemia caused by diabetic ketoacidosis was reported owing to its rareness
📌 3 Key Takeaways
Abstract
A 57-year-old woman with no prior history was admitted to our emergency department with complaints of chest pain, dyspnea, xerostomia, syncope, and cyanosis on her lips and feet. On her physical examination, cyanosis, tachypnea, hypotension and sinus tachycardia were revealed. On the spiral computed tomography of the thorax of the patient with diabetic ketoacidosis, thrombus was detected in the left and right main pulmonary artery and segmental branches of the right pulmonary artery. The fibrinolytic treatment was initiated in the emergency department for the patient with hemodynamic shock due to the diagnosis of acute massive pulmonary embolism. Etiological examinations revealed B12 deficiency and hyperhomocysteinemia. This case, with the presentation of massive pulmonary embolism, resulted from the synergistic effect of hyperhomocysteinemia associated with B12 deficiency; hypovolemia caused by diabetic ketoacidosis was reported owing to its rareness
Özet
öğüs ağrısı, ağız kuruluğu, bayılma, dudak ve ayaklarda morarma, nefes darlığı yakınmaları ile acil servisimize başvuran 57 yaşında kadın hastada, hipotansiyon, taşikardi, takipne ve siyanoz saptandı. Diyabetik ketoasidozu olan hastanın spiral toraks bilgisayarlı tomografisinde, sol ve sağ ana pulmoner arter ile sağ pulmoner arterin segmental dallarında trombüs saptandı. Hemodinamik şok tablosundaki hastaya acil serviste masif pulmoner emboli tanısıyla fibrinolitik tedavi başlandı. Etiyolojiye yönelik yapılan araştırmalarda B12 eksikliği ve hiperhomosisteinemi saptandı. Diyabetik ketoasidozun yarattığı hipovolemi ve B12 eksikliğine bağlı hiperhomosisteineminin sinerjist etkisi ile oluşan masif pulmoner embolinin birlikte görüldüğü bu olgu nadir görülmesi nedeniyle sunuldu.