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Papers of the Week

2019 May

J Family Med Prim Care



Rare cause of stroke in young: Iron deficiency anemia and diabetic ketoacidosis.


Sukdev M, Sweety K, Dhar M, Panda P K
J Family Med Prim Care. 2019 May; 8(5):1775-1777.
PMID: 31198755.


Iron deficiency anemia (IDA) is a well-known cause of stroke in children, but its association is relatively rare in adults. We describe a case of 36-year-old woman, a known diabetes mellitus, who presented with recurrent vomiting, headache, and altered sensorium. Investigations revealed severe iron deficiency anemia, thrombocytosis, and ketoacidosis. Magnetic resonance imaging suggested acute infarct of B/L parieto-occipito-temporo-cerebellar region. Patient was worked up for possible causes of stroke in young. She underwent computed tomography angiography of the brain, echocardiogram, and screening for thrombophilia disorders. This, however, did not demonstrate a clear etiology and there were no other evidences of diabetic angiopathy. Some previously published case reports have suggested IDA as a potential cause of ischemic stroke; it is possible that the stroke in this young woman was attributable to severe IDA. Whether cerebrovascular accident has led to diabetic ketoacidosis or vice versa is a topic of discussion which needs further studies. Moreover, such catastrophes could be prevented by early diagnosis and timely management through involvement of primary care physicians.