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Peripheral neuropathy as a complication of diabetic ketoacidosis in a child with newly diagnosed diabetes type 1 – case report.

Peripheral neuropathy as a complication of diabetic ketoacidosis in a child with newly diagnosed diabetes type 1 – case report.
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Baszyńska-Wilk M, Wysocka-Mincewicz M, Świercz A, Świderska J, Marszał M, Szalecki M,


Baszyńska-Wilk M, Wysocka-Mincewicz M, Świercz A, Świderska J, Marszał M, Szalecki M, (click to view)

Baszyńska-Wilk M, Wysocka-Mincewicz M, Świercz A, Świderska J, Marszał M, Szalecki M,

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Journal of clinical research in pediatric endocrinology 2017 12 08() doi 10.4274/jcrpe.5374
Abstract
BACKGROUND
Neurological complications of diabetic ketoacidosis are considered to be very serious clinical problem. The most common complication is cerebral edema. However this group includes also less common syndromes such as ischemic or hemorrhagic stroke, cerebral venous and sinus thrombosis or very rare peripheral neuropathy.

CASE REPORT
We present a case of 9-year old girl with new onset type 1 diabetes, diabetic ketoacidosis, cerebral edema, multifocal vasogenic brain lesions and lower limbs peripheral paresis. The patient developed polydipsia and polyuria one week before admission to the hospital. In laboratory tests initial blood glucose level 1136 mg/dl and acidosis (pH 7.1; BE-25.9) were noted. She was admitted to the hospital in a critical condition and required treatment in intensive care unit. Computed tomography scan showed brain edema and hipodense lesion in the left temporal region. Brain MRI revealed more advanced multifocal brain lesions Nerve conduction studies demonstrated damage of the motor neuron in both lower extremities with dysfunction in both peroneal nerves and the right tibial nerve. As a result of diabetological, neurological treatment and physiotherapy patient’s health state gradually improved.

CONCLUSIONS
Acute neuropathy after ketoacidosis is rare complication and its pathomechanism is not clear. Patients with DKA require careful monitoring of neurological functions even after normalization of glycemic parameters.

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