Clinical findings of acute necrotizing esophagitis complicated by diabetic ketoacidosis
Acute necrotizing esophagitis (ANE) is a rare and potentially life-threatening complication of diabetic ketoacidosis (DKA). While its association with DKA is established, specific clinical characteristics that predict ANE in DKA patients remain less understood. This study aimed to identify these cha...
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| Format: | Article |
| Language: | English |
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The Japan Endocrine Society
2024-05-01
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| Series: | Endocrine Journal |
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| Online Access: | https://www.jstage.jst.go.jp/article/endocrj/71/5/71_EJ23-0516/_html/-char/en |
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| author | Yuichiro Iwamoto Tomohiko Kimura Takashi Itoh Shigehito Mori Taku Sasaki Mana Ohnishi Haruka Takenouchi Hideyuki Iwamoto Junpei Sanada Yoshiro Fushimi Yukino Katakura Fuminori Tatsumi Masashi Shimoda Shuhei Nakanishi Tomoatsu Mune Kohei Kaku Hideaki Kaneto |
| author_facet | Yuichiro Iwamoto Tomohiko Kimura Takashi Itoh Shigehito Mori Taku Sasaki Mana Ohnishi Haruka Takenouchi Hideyuki Iwamoto Junpei Sanada Yoshiro Fushimi Yukino Katakura Fuminori Tatsumi Masashi Shimoda Shuhei Nakanishi Tomoatsu Mune Kohei Kaku Hideaki Kaneto |
| author_sort | Yuichiro Iwamoto |
| collection | DOAJ |
| description | Acute necrotizing esophagitis (ANE) is a rare and potentially life-threatening complication of diabetic ketoacidosis (DKA). While its association with DKA is established, specific clinical characteristics that predict ANE in DKA patients remain less understood. This study aimed to identify these characteristics by analyzing data from 30 DKA patients admitted from January 2018 to September 2022. Seven patients in this study presented with ANE, forming the ANE group. The remaining 23 constituted the non-ANE group. We compared the clinical parameters and computed tomography (CT) between the groups. The mean age of participants was 57.7 ± 20.4 years, and their mean HbA1c was 11.1 ± 3.3%. Notably, ethanol intake was significantly higher in the ANE group (44.4 ± 25.4 g/day) compared to the non-ANE group (6.8 ± 14.0 g/day; p = 0.013). Additionally, sodium-glucose transport protein 2 inhibitor use was significantly more prevalent in the ANE group (p = 0.013). Gastrointestinal symptoms were also significantly more pronounced in the ANE group, with vomiting occurring in 85.7% of patients compared to only 13.0% in the non-ANE group. Admission CT scans revealed further distinguishing features, with the ANE group showing significantly higher rates of esophageal wall thickening, intra-esophageal effusion, and calcification of the celiac artery origin (p < 0.0001, 0.0038, 0.0038, respectively). In conclusion, our study suggests that heavy alcohol consumption and strong gastrointestinal symptoms in DKA patients warrant a heightened suspicion of ANE. Early consideration of CT or upper gastrointestinal endoscopy is recommended in such cases. |
| format | Article |
| id | doaj-art-f7540c61ee4e49968846ff7360a6439e |
| institution | Kabale University |
| issn | 1348-4540 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | The Japan Endocrine Society |
| record_format | Article |
| series | Endocrine Journal |
| spelling | doaj-art-f7540c61ee4e49968846ff7360a6439e2025-01-22T06:39:10ZengThe Japan Endocrine SocietyEndocrine Journal1348-45402024-05-0171548148810.1507/endocrj.EJ23-0516endocrjClinical findings of acute necrotizing esophagitis complicated by diabetic ketoacidosisYuichiro Iwamoto0Tomohiko Kimura1Takashi Itoh2Shigehito Mori3Taku Sasaki4Mana Ohnishi5Haruka Takenouchi6Hideyuki Iwamoto7Junpei Sanada8Yoshiro Fushimi9Yukino Katakura10Fuminori Tatsumi11Masashi Shimoda12Shuhei Nakanishi13Tomoatsu Mune14Kohei Kaku15Hideaki Kaneto16Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki 701-0192, JapanAcute necrotizing esophagitis (ANE) is a rare and potentially life-threatening complication of diabetic ketoacidosis (DKA). While its association with DKA is established, specific clinical characteristics that predict ANE in DKA patients remain less understood. This study aimed to identify these characteristics by analyzing data from 30 DKA patients admitted from January 2018 to September 2022. Seven patients in this study presented with ANE, forming the ANE group. The remaining 23 constituted the non-ANE group. We compared the clinical parameters and computed tomography (CT) between the groups. The mean age of participants was 57.7 ± 20.4 years, and their mean HbA1c was 11.1 ± 3.3%. Notably, ethanol intake was significantly higher in the ANE group (44.4 ± 25.4 g/day) compared to the non-ANE group (6.8 ± 14.0 g/day; p = 0.013). Additionally, sodium-glucose transport protein 2 inhibitor use was significantly more prevalent in the ANE group (p = 0.013). Gastrointestinal symptoms were also significantly more pronounced in the ANE group, with vomiting occurring in 85.7% of patients compared to only 13.0% in the non-ANE group. Admission CT scans revealed further distinguishing features, with the ANE group showing significantly higher rates of esophageal wall thickening, intra-esophageal effusion, and calcification of the celiac artery origin (p < 0.0001, 0.0038, 0.0038, respectively). In conclusion, our study suggests that heavy alcohol consumption and strong gastrointestinal symptoms in DKA patients warrant a heightened suspicion of ANE. Early consideration of CT or upper gastrointestinal endoscopy is recommended in such cases.https://www.jstage.jst.go.jp/article/endocrj/71/5/71_EJ23-0516/_html/-char/enacute necrotizing esophagitisdiabetic ketoacidosisalcoholcomputed tomographydiabetes mellitus |
| spellingShingle | Yuichiro Iwamoto Tomohiko Kimura Takashi Itoh Shigehito Mori Taku Sasaki Mana Ohnishi Haruka Takenouchi Hideyuki Iwamoto Junpei Sanada Yoshiro Fushimi Yukino Katakura Fuminori Tatsumi Masashi Shimoda Shuhei Nakanishi Tomoatsu Mune Kohei Kaku Hideaki Kaneto Clinical findings of acute necrotizing esophagitis complicated by diabetic ketoacidosis Endocrine Journal acute necrotizing esophagitis diabetic ketoacidosis alcohol computed tomography diabetes mellitus |
| title | Clinical findings of acute necrotizing esophagitis complicated by diabetic ketoacidosis |
| title_full | Clinical findings of acute necrotizing esophagitis complicated by diabetic ketoacidosis |
| title_fullStr | Clinical findings of acute necrotizing esophagitis complicated by diabetic ketoacidosis |
| title_full_unstemmed | Clinical findings of acute necrotizing esophagitis complicated by diabetic ketoacidosis |
| title_short | Clinical findings of acute necrotizing esophagitis complicated by diabetic ketoacidosis |
| title_sort | clinical findings of acute necrotizing esophagitis complicated by diabetic ketoacidosis |
| topic | acute necrotizing esophagitis diabetic ketoacidosis alcohol computed tomography diabetes mellitus |
| url | https://www.jstage.jst.go.jp/article/endocrj/71/5/71_EJ23-0516/_html/-char/en |
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