Myocardial injury in a pediatric patient with diabetic ketoacidosis: A case report. Issue 17 (30th April 2021)

• Record Type: Journal Article
• Authors: Shim, Houn Joe; Yoo, Byung Min; Jin, Seon Mi; Kang, Min Jae
• Other Names: Saranathan. Maya section editor.
• Is Part Of: Medicine. Volume 100:Issue 17(2021)
• Publication Date: 2021-04-30
• Subjects: child -- diabetes complications -- diabetic ketoacidosis -- troponin I; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000025702
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: Diabetic ketoacidosis (DKA) can cause several complications. Among them, cardiac complications are the most fatal and difficult to detect. Cardiac markers are prognostic factors for morbidity and mortality in adult patients with DKA. But, there have been very few discussed cases in pediatrics. We report a case of severe DKA in child with elevated cardiac enzymes and prolonged QT interval. Patient concerns: A 12-year-old girl admitted by nausea, vomiting, and lethargy for 1 day. Diagnoses: Her blood sugar level was initially undetectable by the capillary blood glucose meter, and blood gas analysis showed severe DKA with elevated cardiac enzymes and prolonged QT interval. Interventions: The patient was admitted to hospital and intensive intravenous fluid and regular insulin infusion were administered. Outcomes: After 5 days of supportive care, the patient was fully recovered, discharged, and followed up in an outpatient clinic. Lessons: Since the relationship between DKA and myocardial injury has not been clearly elucidated, pediatricians and emergency physicians should remain careful throughout the recovery time as it can lead to life-threatening conditions in various courses.