Enfoque diagnóstico y terapéutico de la cetoacidosis diabética en  niños y adolescentes en el servicio de urgencias

Introduction:. Patients with Down syndrome (DS) have an increased risk of developing autoimmune diseases. This is a rare case of a pediatric patient with DS with an initial clinical profile of diabetic ketoacidosis.Case presentation:. 6-year-old male patient with symptoms suggestive of diabetes mellitus type 1 (DM1) of 15 days of evolution (polyuria, polydipsia, polyphagia and loss of 2 kilos of weight), who was admitted to the emergency department of the Hospital de San José, in Bogotá, Colombia, with uncontrollable vomiting and dehydration. The tests performed confirmed moderate ketoacidosis: glycometry: 592 mg/dL, pH: 7.19, HCO3: 10 mmol/L, PCO2: 45, PO2: 95 and lactic acid: 1.4 mmol/L. Management with isotonic fluids and intravenous insulin therapy was initiated and the patient was transferred to the pediatric intensive care unit, where ketoacidosis was controlled in approximately 10 hours. Subcutaneous insulin schedule was initiated without complications.Discussion:. This case highlights the importance of monitoring possible autoimmune complications in patients with DS, since the risk of developing them is 4.2 times higher than in the general population.Conclusion:. This case calls on to contemplate autoimmune complications in patients with DS during clinical practice. Although they are not part of the most frequent reasons for consultation, they cannot be underestimated and should be suspected and treated in a timely manner.

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Pediatric diabetic ketoacidosis in a patient with Down syndrome. Case report

Camacho

Guerrero

Figueroa

et al. 2019

Case reports

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Cetoacidosis Diabética

2022

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La cetoacidosis diabética (CAD), constituye una de las complicaciones más severas de la diabetes determinada por la tríada: hiperglucemia, acidosis metabólica y cetosis, siendo la hiperglucemia un principio clave para la valoración de CAD; no obstante, en inusuales ocasiones los niveles de glucemia pueden localizarse en rangos normales, entidad conocida como CAD euglucémica, caracterizada clínicamente por alteración del sensorio de grado variable, pérdida de electrolitos, hiperosmolaridad extracelular y deshidratación. Desde el punto de vista bioquímico la CAD se caracteriza por glucemia mayor de 250mg/dl, cuerpos cetónicos positivos en orina o suero, la acidosis metabólica a pH menor o igual a 7.30 con anión gap elevado (más de 10), además el bicarbonato plasmático disminuye a valores iguales o menores de 18 mEq/l.

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Enfoque diagnóstico y terapéutico de la cetoacidosis diabética en niños y adolescentes en el servicio de urgencias

Cited by 2 publications

References 63 publications

Pediatric diabetic ketoacidosis in a patient with Down syndrome. Case report

Pediatric diabetic ketoacidosis in a patient with Down syndrome. Case report

Cetoacidosis Diabética

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