title: Severe diabetic ketoacidosis leading to cardiac failure, pulmonary oedema and spinal cord oedema resulting in tetraplegia.
abstract: A 23-year-old man with poorly controlled insulin-dependent diabetes mellitus presented to casualty with community-acquired pneumonia and diabetic ketoacidosis. Shortly after admission he deteriorated and developed cardiac failure, pulmonary oedema and further decreased level of consciousness. He was sedated and ventilated for 3 weeks in the intensive care unit. On waking from sedation he was found to be tetraplegic. MRI scan showed gross oedema of the cervical spinal cord with area suspicious of infarction. We describe a rare cause of spinal cord injury and discuss the proposed hypotheses.
authors.affiliation: Department of Urology, Southport and Ormskirk Hospital NHS Trust, Southport, UK. ematmichelle@hotmail.com
authors.forename: Michelle
authors.initials: M
authors.lastname: Christodoulidou
authors.forename: Fahed
authors.initials: F
authors.lastname: Selmi
mesh_terms: D016883:Diabetic Ketoacidosis / Q000150:complications*; D004487:Edema / Q000209:etiology*; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D008297:Male; D011654:Pulmonary Edema / Q000209:etiology*; D011782:Quadriplegia / Q000209:etiology*; D012720:Severity of Illness Index; D013118:Spinal Cord Diseases / Q000209:etiology*; D055815:Young Adult