A Rare Case of Bronze Diabetes Presenting as Diabetes Ketoacidosis

Abstract

A decrease in the beta globulin chain, or thalassemia major, can lead to splenomegaly, extramedullary haematopoiesis, and severe anaemia. Iron overload occurs as a result of the mandatory blood transfusions required by thalassemia major patients to maintain acceptable erythrocyte levels. Secondary haemochromatosis, often known as bronze diabetes, is a fatal medical disease that may arise as a result of multiple blood transfusions. A 16-year-old male presented with complaints of polyuria, polydipsia and breathlessness in EMR. His random blood sugar was 564mg/dl, serum ketones were positive, arterial blood gas analysis showed high anion gap acidosis. His mother informed the patient was known case of thalassemia major since five years of age and was undergoing blood transfusions every 21 days along with chelation therapy. The patient was diagnosed to have diabetic ketoacidosis and was stabilized. Diffuse hyperpigmentation was evident on the sun-exposed areas of skin. Diagnosed as bronze diabetes the patient is on multiple doses of insulin and on chelation therapy