Fulminant Type 1 Diabetes Complicated by Leukemoid Reaction

Naoko Obi, Takuyuki Katabami, Shiko Asai, Nobuhiko Saito, Yasushi Tanaka
2008 Internal medicine (Tokyo. 1992)  
A 28-year-old woman with severe ketoacidosis was admitted to our hospital on day 11 after giving birth. However, her HbA1C level was normal (5.2%) and both GAD and anti-insulin autoantibody were negative, and the WBC count was extremely high (57,500/ml) with immature leucocytes in the peripheral blood. Her WBC count decreased along with control of ketoacidosis and reduction of the plasma glucose level, and was normalized on day 5 after admission. Bone marrow aspiration subsequently showed no
more » ... uently showed no malignant cells, so the final diagnosis was fulminant type 1 diabetes combined with a leukemoid reaction. This is the first report of a patient with both fulminant type 1 diabetes and a leukemoid reaction. The mechanism that triggered the leukemoid reaction could not be clarified, but severe ketoacidosis may have been involved.
doi:10.2169/internalmedicine.47.0706 pmid:18451578 fatcat:omhgzzrtdbcszjjrkn26cnugwq