Diabetic ketoacidosis associated with Guillain-Barre syndrome with autonomic dysfunction

A 37-year-old woman was admitted in a comatose state, after exhibiting feve r and diarrhea. Diabetic ketoacidosis was diagnosed due to an increased blo od glucose level (672 mg/dl), metabolic acidosis, and positive urinary keto ne bodies. On the fifth hospital day, despite recovery from the critical st ate of ketoacidosis, the patient suffered from dysphagia, hypesthesia and m otor weakness, followed by respiratory failure. Cerebrospinal fluid analysi s was suggestive of Guillain-Barre syndrome (GBS), Autonomic dysfunction wa s manifested as tachycardia and mild hypertension in the acute stage, Marke d orthostatic hypotension persisted long after paresis was improved, indica ting an atypical clinical course of GBS.