Acute hypoxic hepatopathy: diabetic ketoacidosis complication in an infant newly diagnosed with type 1 diabetes mellitus.
OBJECTIVE
Case presentation of hepatic dysfunction after severe ketoacidosis in an infant newly diagnosed with type 1 diabetes mellitus.


METHODS
A 10-month old Caucasian boy has been admitted to the hospital with pH 6.85, body temperature of 39.9 degrees C and plasma glucose 145 mmol/l. The patient was diagnosed with type 1 diabetes mellitus complicated by diabetic ketoacidosis and otitis media. During the next 48 hours of treatment glucose level and acidosis have normalized. On the 3 day, laboratory tests showed a rapid increase in AST and ALT levels to 8000 IU/L and 6000 IU/L, respectively; INR=2.9. A gradual decrease of transaminase level was observed on the 5 day, while during the next weeks all liver function tests normalized. The patient was recognized with ischemic hepatitis based on abnormal biochemical tests and exclusion of viral infection and hepatotoxic agents.


CONCLUSIONS
Diabetic ketoacidosis complicated by hypovolemic shock, infection and profound metabolic decompensation may lead to hypoxic hepatopathy in infants.
Szypowska
Agnieszka
A
Department of Diabetology, Neonatology and Birth Defects, Medical University of Warsaw. agnieszka.szypowska@gmail.com
Skórka
Agata
A
Pańkowska
Ewa
E
D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000175:diagnosis*; D016883:Diabetic Ketoacidosis / Q000150:complications* / Q000175:diagnosis*; D006505:Hepatitis / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007223:Infant; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology; D008099:Liver / Q000098:blood supply; D008297:Male; D010033:Otitis Media / Q000150:complications; D012769:Shock / Q000150:complications