ESPE Abstracts (2016) 86 P-P2-325

Diabetic Ketoacidosis and Multiple Organ Failure Syndrome: A Case Study

Bui Thao Phuong, Vu Dung Chi, Nguyen Khanh Ngoc & Can Ngoc Thi Bich


Vietnam National Hospital of Pediatrics, Hanoi, Vietnam


Background: Multiple organ failure syndrome (MOFS) can occur in diabetic ketoacidosis (DKA).

Objective and hypotheses: A 6-year old female child had DKA and MOFS.

Method: We presented a case study of a child with DKA and MOFS.

Results: A 6-year old female child had 1-week history of excessive thirst, polyuria, polydipsia, and weight loss. One day before coming to Vietnam National Hospital of Pediatrics (NHP), she had tiredness, multiple vomiting, lethargy, and she was required to give IV 1000 ml of normal saline in a local hospital and transferred to NHP. On admission to NHP, she had tachypnea, unconsciousness with Glasgow score of 6, severe dehydration, hypovolemic shock. In term of investigation, glucose lever was 32.2 mmol/l; metabolic acidosis with pH of 6.8; hypernatremia with sodium level of 162 mmol/l; ketonuria and glucosuria; HbA1C of 12.1%; low C-peptide of 0.001 ng/ml; increased liver enzymes with GOT and GPT of 470 and 188 U/l, respectively; renal failure with urea and creatinine of 27.9 and 318 mmol/l, respectively; rhadomyolysis with CK of 29642 U/l; myoglobinuria. She was diagnosed of DKA, DM1, and MOFS. Besides DKA treatment, she was in continuous veno-venous hemodialysis for 11 days and in intermittent veno-venous hemodialysis for 5 days. DKA and MOFS were cured. Renal function and liver enzymes were recovered. She was discharged from hospital without neurogenic sequalae.

Conclusion: Hemodialysis is an appropriate treatment for a combination of DKA and MOFS.

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