Ketoacidosis, Hypertriglyceridemia and Acute Pancreatitis Induced by Soft Drink Polydipsia in a Patient with Occult Central Diabetes Insipidus

• Published in: Internal Medicine Vol. 61; no. 3; pp. 365 - 371
• Main Authors: Tsujimoto, Yasutaka, Nakamura, Tomoaki, Onishi, Jun, Ishimaru, Naoto, Iwata, Naoko, Fujisawa, Haruki, Suzuki, Atsushi, Sugimura, Yoshihisa, Chihara, Kazuo
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01-02-2022; Japan Science and Technology Agency
• Subjects: Acute Disease; acute pancreatitis; Adult; anti-rabphilin-3A antibody; Beverages; Carbonated Beverages - adverse effects; Case Report; central diabetes insipidus; Coexistence; Dehydration; Diabetes; Diabetes Insipidus; Diabetes Insipidus, Neurogenic; Diabetes Mellitus; Humans; Hypertriglyceridemia; Hypertriglyceridemia - complications; Hypertriglyceridemia - diagnosis; Internal medicine; Ketoacidosis; Ketosis; lymphocytic infundibulo-neurohypophysitis; Male; Pancreatitis; Pancreatitis - complications; Pancreatitis - diagnosis; Pituitary (posterior); Polydipsia; Polydipsia - diagnosis; Polydipsia - etiology; Polyuria; soft drink ketosis; Soft drinks; Thirst; Young Adult; central diabetes insipidus; ketoacidosis; anti-rabphilin-3A antibody; soft drink ketosis; acute pancreatitis; lymphocytic infundibulo-neurohypophysitis
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.7663-21

A 21-year-old Japanese man without known diabetes mellitus had abdominal pain. The diagnosis was ketoacidosis and hypertriglyceridemia-induced acute pancreatitis. He had polydipsia and polyuria and had habitually drunk several soft drinks every day for two years. After hospitalization, despite adequate liquid intake, dehydration remained with hypotonic polyuria. Further examinations revealed the coexistence of central diabetes insipidus (CDI), possibly caused by lymphocytic infundibulo-neurohypophysitis, based on anti-rabphilin-3A antibody positivity. Although CDI had been undiagnosed for two years, over-consumption of sugar-rich soft drinks to ease thirst caused ketoacidosis, hypertriglyceridemia, and acute pancreatitis. There are no previous reports of this three-part combination of symptoms caused by CDI.