Diabetic Ketoacidosis, Hypertriglyceridemia and Abdominal Pain due to Acute Pancreatitis Complicated by Non-immune Haemolytic Anaemia.

The triad of diabetic ketoacidosis, acute pancreatitis and hypertriglyceridemia is a rare phenomenon, with mortality rates of up to 80%. A unique characteristic of the described case is the co-occurrence of non-immune haemolytic anaemia (NIHA) with the complex triad. It is suggested that this presentation is secondary to hyperlipidemia which leads to increased fragility of erythrocytes due to destabilization of red cell membranes. Supportive treatment with intravenous insulin and blood transfusions is the cornerstone of treatment. LEARNING POINTS: The enigmatic triangle of diabetic ketoacidosis (DKA), hypertriglyceridemia and acute pancreatitis is a rare phenomenon occurring in only 4% of DKA cases.This triad can be complicated by non-immune haemolytic anaemia secondary to hyperlipidemia, which leads to increased fragility of the erythrocyte due to destabilization of red cell membranes.Supportive treatment with intravenous insulin administration and blood transfusions is the cornerstone of treatment. © EFIM 2020.