Generalized venous thrombosis in diabetic ketoacidosis: A case report and review

Diabetic ketoacidosis (DKA) is a medical emergency with multi-organ complications. Venous thromboembolism (VTE) is a rare complication of DKA. We are presenting a 58 year old male patient with poorly controlled type 2 diabetes mellitus who was hospitalized with DKA secondary to noncompliance. His clinical picture was complicated by generalized thrombosis involving multiple venous locations including bilateral femoral and common iliac veins. Because of his increasing shortness of breath, he was also diagnosed with large saddle pulmonary emboli. The patient had no family history or personal history of any coagulation disorders. Hypercoagulability evaluation remained negative. He was subsequently anticoagulated with heparin and discharged home on warfarin. In reviewing the medical literature and to the best of our knowledge, this is one of the few reported cases of multiple venous thromboses occurring as a DKA complication, with no other risk factors for venous thrombosis. This case highlight the fact that venous thrombosis (VTE), although rare, should always be considered as a potential complication of DKA.