Case of the Month #60 The Acidotic Coma: A Case of Unexplained Rigidity

Published 29/01/2026

References

  1. Plewa MC, Bryant M, King-Thiele R. Euglycemic Diabetic Ketoacidosis. StatPearls Publishing; 2025.
  2. Iqbal PMR, Maadarani OS, Bitar ZI. Tirzepatide-induced ketoacidosis in non-diabetic patients. Eur J Case Rep Intern Med. 2024;11(4):004357. doi:10.12890/2024_004357
  3. Bitar Z, Abdelraouf HM, Maig RA, Maadarani O, Bitar ZZ, Dashti H. Exploring hypoglycemic ketoacidosis in nondiabetic patients on tirzepatide: is starvation the culprit? Am J Case Rep. 2024;25:e946133. doi:10.12659/AJCR.946133 
  4. Nasa P, Chaudhary S, Shrivastava PK, Singh A. Euglycemic diabetic ketoacidosis: a missed diagnosis. World J Diabetes. 2021;12(5):514-523. doi:10.4239/wjd.v12.i5.514
  5. Collins L, Costello RA. Glucagon-Like Peptide-1 Receptor Agonists. StatPearls Publishing; 2025.
  6. Bettge K, Kahle M, Abd El Aziz MS, Meier JJ, Nauck MA. Occurrence of nausea, vomiting and diarrhea reported as adverse events in clinical trials studying glucagon-like peptide-1 receptor agonists: a systematic analysis of published clinical trials. Diabetes Obes Metab. 2017;19(3):336-347. doi:10.1111/dom.12824
  7. Kopec KT, Kowalski MJ. Metformin-associated lactic acidosis (MALA): case files of the Einstein Medical Center medical toxicology fellowship. J Med Toxicol. 2013;9(1):61-66. doi: 10.1007/s13181-012-0278-3