A rare presentation of diabetic ketoacidosis: meningeal syndrome

Diabetic ketoacidosis (DKA) typically presents with abdominal pain, vomiting, fatigue, and excessive thirst. Although it is a state of acidosis, symptoms related to the central nervous system are not frequent in DKA. We here report our experience of a patient with DKA receiving immunosuppressive drugs due to renal transplantation who initially presented with the meningeal syndrome. The condition resolved quickly after correction of acidosis and hyperglycemia. In this particular case, we had clues for drug-related side effects of immunosuppressants that possibly facilitated the occurrence of meningeal irritation. Our observations may contribute to the care of patients with DKA who are on such treatment regimens. Date submitted: May 09, 2019 Date accepted: Jul 22, 2019 Online publication date: September 15, 2019 Corresponding Author: Bilgin Bahadır Başgöz Turkish Ministry of Health, Gülhane Training and Research Hospital, Department of Internal Medicine, Ankara, Turkey bbbasgoz@gmail.com