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Pantoprazole-induced liver injury in the setting of diabetic ketoacidosis

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Critically ill patients are at higher risk of acquired liver in-jury, given the multiple coexisting potential causes of injury.1They are also at risk of stress ulcers, and prophylaxis with proton pump inhibitors (PPIs) is common in Intensive Care Units (ICUs). A 54-year-old woman was admitted to the ICU due to diabetic ketoacidosis (DKA). On admission, she was hemo-dynamically stable, with a Glasgow Coma Scale score of 7 (E2V1M4). Her abdominal examination was normal, without palpable organomegalies, and her liver blood tests were within the normal range. She was intubated for airway pro-tection and started on intravenous fluids, insulin perfusion, and prophylaxis with intravenous pantoprazole 40 mg/day.

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Chemical and Drug Induced Liver Injury Diabetic Ketoa-cidosis Pantoprazole Cetoacidose Diabética Lesões Hepáticas Induzidas por Produtos Químicos e Medicamentos Pantoprazol

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