1/4. Ketoacidosis and hyperosmolarity as first symptoms of type 1 diabetes mellitus following ingestion of high-carbohydrate-containing fluids.The concomitant occurrence of diabetic ketoacidosis and hyperosmolarity is reported in two children, as early symptoms of misdiagnosed type 1 diabetes mellitus. The precipitating factor for both severe metabolic abnormalities was the ingestion of a large amount of high-carbohydrate-containing fluids, a few days before admission. A similar situation has never been reported before in the literature. A successful therapeutic scheme is described.- - - - - - - - - - ranking = 1keywords = ketoacidosis (Clic here for more details about this article) |
2/4. Brugada pattern electrocardiographic changes associated with profound electrolyte disturbance.Only a few case reports of Brugada pattern ECG changes caused by electrolyte disturbance exist in the literature, all of which lack adequate electrophysiological exclusion (or inclusion) of an underlying brugada syndrome. This report describes a case of an otherwise healthy 38-year-old man who presented to the hospital with diabetic ketoacidosis, profound electrolyte disturbance, and Brugada pattern ECG changes. Subsequent flecanide drug challenge and electrophysiological studies ruled out an underlying brugada syndrome.- - - - - - - - - - ranking = 1keywords = ketoacidosis (Clic here for more details about this article) |
3/4. The use of continuous hemodiafiltration in a patient with diabetic ketoacidosis.A variety of fatal complications are associated with diabetes mellitus. Among these, diabetic ketoacidosis (DKA) figures largely in fatalities in young diabetics. Although hyperosmotic diuresis in DKA causes extreme fluid loss, acute renal failure is less common than expected in DKA. We treated a case of severe DKA with associated coma, acute respiratory failure, and acute renal failure in a 24-year-old man who had been diagnosed with type 1 diabetes mellitus at age 19. The comatose patient had been intubated before transfer to our hospital for intensive care. Despite infusion with isotonic saline and insulin, metabolic acidosis was refractory. On day 2, urine output decreased and pulmonary congestion developed, so we started continuous veno-venous hemodiafiltration (CVVHDF), which was effective against the metabolic acidosis; urine output increased gradually. CVVHDF was withdrawn on day 7, and the patient's renal function recovered completely. He was discharged from the intensive care unit (ICU) on day 14.- - - - - - - - - - ranking = 5keywords = ketoacidosis (Clic here for more details about this article) |
4/4. Cerebral edema complicating therapy for diabetic ketoacidosis.Four cases of cerebral edema associated with therapy for diabetic ketoacidosis are reported. One patient had an inappropriate ADH-like syndrome at the time of onset of clinical symptoms of cerebral edema; he survived. The remaining patients had hyponatremia at or near the time of onset of clinical symptoms of cerebral edema, and they subsequently died. The literature is reviewed and some aspects of therapy, which might be casually related to cerebral edema observed in association with therapy of diabetic ketoacidosis, are discussed.- - - - - - - - - - ranking = 6keywords = ketoacidosis (Clic here for more details about this article) |