Insulin
- PDF / 169,681 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 25 Downloads / 189 Views
1 S
Lack of efficacy: case report A 5-year-old girl exhibited lack of efficacy during treatment with insulin and unspecified fluids for diabetes mellitus and diabetic ketoacidosis. The previously healthy girl presented to the emergency department due to weight loss for two weeks, and polyuria and polydipsia for three days. Upon presentation, blood tests revealed glucose 433 mg/dL, pH 7.05, bicarbonate < 5 mmol/L, potassium 4.5 mmol/L, anion gap of 29 and haemoglobin A1c 16.9%. Urinalysis showed presence of large ketones. She was lethargic. Episodes of emesis and complaints of abdominal tenderness prompted an abdominal x-ray, which showed findings consistent with constipation. New-onset diabetes mellitus in diabetic ketoacidosis was suspected. She was treated with insulin and unspecified fluids [routes and dosages not stated]. However, her condition failed to improve over the first 8h. With fluid resuscitation, the girl’s neurologic status improved initially. However, she was acutely decompensated with haemodynamic instability. A bedside laparotomy showed frank intestinal necrosis with perforation. Thirteen hours following the initial presentation, she died. An autopsy confirmed the cause of death as extensive mucosal necrosis of the small and large bowel, and Clostridium perfringens septic shock. Guarneri A, et al. Intestinal necrosis and clostridium perfringens sepsis in a patient with diabetic ketoacidosis: A rare cause of mortality. Hormone Research in Paediatrics 93 803506227 (Suppl. 1): 87, Jul 2020. Available from: URL: http://doi.org/10.1159/000509566 [abstract]
0114-9954/20/1825-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
Reactions 10 Oct 2020 No. 1825
Data Loading...
