Progressive decrease in N-acetylaspartate/Creatine ratio in a teenager with type 1 diabetes and repeated episodes of ketoacidosis without clinically apparent cerebral edema: Evidence for permanent brain injury.
Recent data suggest that DKA may contribute to cognitive impairment in children with type 1 DM. We measured the NAA/Cr ratio in a teenager during and following 2 separate episodes of DKA without clinically apparent cerebral edema. The NAA/Cr ratio decreased during DKA and improved following recovery. However, the NAA/Cr value was lower after the second episode of DKA (1.76) than after the first (1.97). These findings provide support for the hypothesis that neuronal injury may result from DKA.
Wootton-Gorges
S L
SL
Departments of Radiology, University of California, Davis School of Medicine and UC Davis Children's Hospital, Sacramento, USA. sandra.gorges@ucdmc.ucdavis.edu
Buonocore
M H
MH
Caltagirone
R A
RA
Kuppermann
N
N
Glaser
N S
NS
D000293:Adolescent; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001479:Basal Ganglia / Q000502:physiology; D001786:Blood Glucose / Q000378:metabolism; D001921:Brain / Q000503:physiopathology*; D001925:Brain Damage, Chronic / Q000175:diagnosis* / Q000503:physiopathology; D001929:Brain Edema / Q000175:diagnosis* / Q000503:physiopathology; D003401:Creatine / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism*; D016883:Diabetic Ketoacidosis / Q000175:diagnosis* / Q000503:physiopathology; D004292:Dominance, Cerebral / Q000502:physiology; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male
D001786:Blood Glucose; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine