Kouame KI, Mobio PMN, Bouh JK, Konan JK, Coulibaly TK, Toure CW, Diebi LAA, Kouakou JNH, Koffi BE, Yapo PY. Convergence of diabetic ketoacidosis, acute pancreatitis, and malaria: A case report. World J Clin Cases 2025; 13(23): 106321 [DOI: 10.12998/wjcc.v13.i23.106321]
Corresponding Author of This Article
Koffi Isidore Kouame, MD, Assistant Chief of Clinic, Unit of Training and Research in Medical Sciences, Félix Houphouët Boigny University, Université Félix Houphouët-Boigny Cocody, Abidjan Côte d'Ivoire, Abidjan 22BP582, Cote d'Ivoire. kouamedocinterne@gmail.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 16, 2025; 13(23): 106321 Published online Aug 16, 2025. doi: 10.12998/wjcc.v13.i23.106321
Convergence of diabetic ketoacidosis, acute pancreatitis, and malaria: A case report
Koffi Isidore Kouame, Paterne Michael N'kan Mobio, Judith Kouesseu Bouh, Jean Kouassi Konan, Theodore Klinnan Coulibaly, Cyrille Wallamitien Toure, Lauraine Armande Assoh Diebi, Jose Ndjassipli Homawoo Kouakou, Bable Essuy Koffi, Paul Yapo Yapo
Koffi Isidore Kouame, Paterne Michael N'kan Mobio, Judith Kouesseu Bouh, Jean Kouassi Konan, Theodore Klinnan Coulibaly, Cyrille Wallamitien Toure, Lauraine Armande Assoh Diebi, Jose Ndjassipli Homawoo Kouakou, Bable Essuy Koffi, Paul Yapo Yapo, Unit of Training and Research in Medical Sciences, Félix Houphouët Boigny University, Abidjan 22BP582, Cote d'Ivoire
Author contributions: Kouame KI, Mobio PMN, and Bouh JK gathered the documents and wrote the manuscript; Konan JK, Coulibaly TK, Toure CW, and Diebi LAA revised the manuscript; Kouakou JNH, Koffi BE, and Yapo PY contributed to the critical review of the manuscript for important intellectual content and provided unique perspectives on the clinical data and valuable suggestions for improving the manuscript; all authors have given their final approval for the submission.
Informed consent statement: Patient consent was obtained of this case.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Koffi Isidore Kouame, MD, Assistant Chief of Clinic, Unit of Training and Research in Medical Sciences, Félix Houphouët Boigny University, Université Félix Houphouët-Boigny Cocody, Abidjan Côte d'Ivoire, Abidjan 22BP582, Cote d'Ivoire. kouamedocinterne@gmail.com
Received: February 24, 2025 Revised: April 14, 2025 Accepted: April 25, 2025 Published online: August 16, 2025 Processing time: 102 Days and 14 Hours
Abstract
BACKGROUND
Type 1 diabetes is an autoimmune disease leading to insulin deficiency, and it is mainly diagnosed in young adults. One of the major acute complications of type 1 diabetes is diabetic ketoacidosis (DKA), which is a metabolic emergency that can be triggered by stress, infection, or poor blood glucose control. The association of DKA with conditions such as acute pancreatitis and malaria is rare and therefore represents a major diagnostic and therapeutic challenge.
CASE SUMMARY
A 20-year-old female was admitted to the emergency room for abdominal pelvic pain, fever, asthenia, polyuria, and polydipsia with a progressive deterioration of her state of consciousness. At admission, she was in a mild coma (Glasgow score: 9), had a fever of 38.5 °C, and had hyperglycemia (6 g/dL). The tests revealed severe DKA, hypertriglyceridemia, hyperamylasemia, and hyperlipasemia as well as malaria parasite density. The computed tomography scan confirmed acute stage E pancreatitis. The diagnosis was that of inaugural ketoacidosis of type 1 diabetes unbalanced by pancreatitis and malaria. Treatment included insulin therapy, rehydration, and antimalarial and analgesic treatment. After 10 days, the outcome was favorable with a normalization of the blood sugar, and an endocrine follow-up was recommend.
CONCLUSION
Rapid and multidisciplinary management of DKA, pancreatitis, and malaria led to a favorable and stable prognosis.
Core Tip: Type 1 diabetes is an autoimmune disease that can lead to serious metabolic disorders, electrolyte imbalances, and acute complications. Malaria impacts inflammation and metabolism and can aggravate diabetic ketoacidosis and electrolyte imbalances associated with type 1 diabetes, complicating clinical management of the patient. Prompt and targeted treatment is essential to avoid serious decompensation of the patient and ensure a favorable outcome. It is therefore essential to consider malaria as an aggravating factor when diagnosing and treating complications of type 1 diabetes.
