Soft Drink Ketosis Associated with Type III Hyperlipidemia and Diabetic Xanthoma, Case Report

Abstract

A 42-year-old man was referred to our hospital because of oral dysesthesia and thirst, and was immediately admitted, based on a diagnosis of diabetic ketosis (PG 1181 mg/dl) caused by excessive consumption of soft drinks.Physical examination revealed multiple small yellowish papular eruptions over the extensor surface of both elbows and the left knee. His total cholesterol and triglyceride levels were 283 mg/dl and 566 mg/dl, respectively.Lipoprotein electrophoresis yielded a broaβ-lipoproteinemic pattern, and his apoprotein-E phenotype was E 2/2. Based on these findings and the skin biopsy findings, his eruptions were diagnosed as tubero-eruptive xanthomas associated with type DI hyperlipidemia. The xanthomas developed suddenly in association with hyperglycemia and hyperlipidemia, and regressed shortly after the patient's glycemic control and hyperlipidemia had improved. These findings were compatible with our diagnosis of diabetic xanthoma.
Diabetic xanthoma is a rare complication of diabetes that occurs in only 0.1% of diabetic patients. This is an interesting case of tubero-eruptive xanthomas associated with typelll hyperlipidemia secondary to uncontrolled diabetes.