Background and Aims. There is growing evidence that the 2019 coronavirus disease (COVID-19) is emerging as a potential trigger virus for the development of diabetes mellitus in children. This can occur even in patients without factors predisposing to impaired glucose metabolism. Here, we report two rare cases of diabetic ketoacidosis revealing new-onset diabetes and precipitated by COVID-19. These cases are reported in view of their rarity and originality. The relationship between type 1 diabetes mellitus and COVID-19 is discussed. Results. Two children developed symptoms suggestive of diabetic ketoacidosis preceded by polyuria, polydipsia, and asbestos. There is a documented COVID-19 infection in the parents of the 2 children. An asymptomatic infection was detected in the 2 patients on the basis of a reverse transcription polymerase chain reaction (RT-PCR) test. Thoracic imaging and inflammatory workup were negative in both cases. Both patients responded well to treatment, including rehydration regimens and intravenous insulin. On the 2nd day of their hospitalization, they were transferred to several injections of subcutaneous insulin with therapeutic and nutritional education from the parents. After about 4 weeks, their insulin requirements probably decreased due to the diabetes honeymoon. Conclusion. COVID-19 can induce acute onset diabetes and diabetic ketoacidosis in children. More research data are needed to improve our knowledge of this constellation and to guide the most appropriate therapies.
Purpose :To report a case of pseudotumor cerebri in a Child associated with coronavirus disease. Methods : A previously 12 year old boy presented to our hospital with a 5 days history of fever,headache,vomiting and general malaise.Initial laboratory investigation revealed significantly elevated neutrophilic leukocytosis and markers of inflammation were significantly elevated, pharyngeal swab for severe acute respiratory syndrome coronavirus (SARS-CoV 2) by polymerase chain reaction was negative , while anti-sars-CoV-2 antibody was highly reactive.Neuro-ophtalmic examination revealed a visual accuity of 20/20 in both eyes with bilateral papilloedema.Neurogical examination was otherwise normal,MRI of the brain and magnetic resonnance venogram revealed abnormalities consistent with increased intracranial pressure.The opnening pressure of cerebrospinal fluid was 40 cmH2O and CSF composition was normal. Results : Based on our patients symptom the diagnostic of pseudotumor cerebri associated with multisystem inflammatory syndrome in child was made and the child was traited with oral acetazolamide.Edema of the optic disc regressed following therapy Conclusion : In conclusion pseudotumor cerebri syndrome may be seen in the content of SARS-CoV-2 infection and should be kept in the differential diagnosis for headache and vision loss in this population. Clinicians need to be aware of this potential neuro-ophtalmic complication in MIS-c diagnosis and treatment can prevent visual loss.
Cytomegalovirus (CMV) is a member of the Herpesviridae family of DNA viruses. It is one of the major infectious causes that induce thrombocytopenia. We herein report a case of CMV infection in an infant complicated with severe thrombocytopenia that was successfully managed by antiviral treatment. A threemonth-old girl presented with generalized petechial lesions in the limbs, trunk, and eyelids, discovered by chance during a vaccination consultation in an apyretic context.Blood examinations demonstrated thrombocytopenia at 26,000/mm 3 . She was diagnosed with immune thrombocytopenic purpura. Intravenous immunoglobulin was administered thrice and corticosteroid therapy at a dose of 2 mg/kg/day was started. The evolution during her hospitalization was marked by the increase to 373,000/mm 3 . A week later, the platelet had decreased again to 8000/mm 3 . Positive serology and high CMV DNA detected in serum by real-time quantitative polymerase chain reaction confirmed the diagnosis of CMV infection. In consideration of the severe thrombocytopenia, antiviral therapy with ganciclovir 5 mg/kg/12 hours was initiated. The platelet counts increased with decreasing CMV loads. She was discharged home after clinical stabilization with a close follow-up over one year.
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