Abstract
Very few cases have been reported which showed only meningeal symptoms during diabetic coma. A 43year old house wife who had no history of diabetes suffered from influenza on 10th of Oct.1974, and gradually began complaining of thirst and nausea and epigastralgia which radiated to the back by Oct. 20 th. She was admitted to the hospital because of somnolence and tremor of the hand. Meningitis or subdural bleeding was suspected from the prevalent signs of nuchal rigidity and Kernig's sign, but was denied by the CSF findings. Muscular defense was noted on her epigastrium. Laboratory examination revealed that the serum amylase was 3420 IU/L, urinary acetone negative, hematocrit 55%, blood sugar 1570 mg/dl, serum Na 149 mEq/L, serum K 4.5 mEq/L, BUN 62.5 mg/dl, serum osmotic pressure 508 mOs/L, pH 7.325 and BE-5.0 mEq/L. From the above data, her condition was diagnosed as non-ketotic hyperosmolar diabetic coma due to acute pancreatitis.
Although the mechanism of such meningeal symptoms during diabetic coma have not been completelyelucidated, dehydration must have been the trigger, because the symptom disappeared 23 hours after infusion of 8000 ml of transfusion fluid.
