title: Diabetic ketoacidosis preceding thrombocytopenia associated multiple organ failure in a child.
abstract: BACKGROUND
  Thrombocytopenia associated multiple organ failure is a rare but increasingly recognized condition in children. Diabetic ketoacidosis preceding thrombocytopenia associated multiple organ failure is previously unreported in pediatric patients.
  
  
  METHODS
  A 12-year-old female presented with diabetic ketoacidosis along with acute pancreatitis. She further developed thrombocytopenia and renal failure over the next two days. Although hemolytic uremic syndrome/thrombotic thrombocytopenic purpura spectrum was considered, the clinical picture seemed most consistent with thrombocytopenia associated multiple organ failure. The patient was treated with serial therapeutic plasma exchanges and made a complete recovery.
  
  
  CONCLUSIONS
  A high index of suspicion of thrombocytopenia associated multiple organ failure is required in patients with diabetic ketoacidosis or pancreatitis who present with thrombocytopenia and renal failure. Plasma exchange is a life-saving intervention in such cases.
authors.affiliation: Department of Pediatrics, Louisiana State University Health Sciences Center, Shreveport, LA, USA. kpeds2008@gmail.com
authors.forename: Kamakshya P
authors.initials: KP
authors.lastname: Patra
authors.forename: L Keith
authors.initials: LK
authors.lastname: Scott
mesh_terms: D000208:Acute Disease; D002648:Child; D016883:Diabetic Ketoacidosis / Q000150:complications*; D003937:Diagnosis, Differential; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000175:diagnosis; D006801:Humans; D009102:Multiple Organ Failure / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D010195:Pancreatitis / Q000150:complications; D010951:Plasma Exchange; D011696:Purpura, Thrombocytopenic / Q000175:diagnosis; D013921:Thrombocytopenia / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome