Diabetic ketoacidosis clinical presentation

The most severe form (f hyperthyroidism is thyroid storm, a rare but life-threatening disease that usually is precipitated by an intercurrent medical problem. Precipitating factors include infections, stress, trauma, thyroidal or nonthyroidal surgery, diabetic ketoacidosis, labor, heart disease, and rarely, radioactive iodine ablation. Clinical features are similar to those of thyrotoxicosis, but are more severe. Cardinal features include fever and tachycardia out of proportion to the fever. Nausea, vomiting, diarrhea, agitation, and confusion are frequent presentations. The abnormalities in TFTs are not necessarily worse than those in uncomplicated thyrotoxicosis and thyroid storm is a clinical diagnosis. 

Once the presence of fasting lipemia has been established, di-ffereyitiation between primary and secondary hyperlipemias can usually be made on the basis of presence or absence of clinical and laboratory findings characteristic of an underlying disease. Plasma lipid and lipoprotein patterns as determined by lipid analyses, ultracentrifugation and electrophoresis are not necessarily diagnostic since similar findings are present in EHL and hyperlipemia of diabetic ketoacidosis, acute pancreatitis, alcoholism, etc. (Schettler 1955, Lees and Fredrickson 1964, Jahnke 1965). 

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