Thrombotic microangiopathic syndrome: a novel complication of diabetic ketoacidosis.
Thrombotic microangiopathic syndrome secondary to diabetic ketoacidosis is an under reported entity in children. We describe 2 girls who developed thrombotic thrombocytopenic purpura (TTP) and thrombocytopenia associated multi organ failure (TAMOF) in new onset diabetes. Both patients presented with classical findings of DKA and were intubated due to low GCS, admitted in PICU and managed according to DKA guidelines. Later on, both patients developed thrombocytopenia, acute kidney injury, and low hemoglobin along with evidence of microangiopathy on peripheral smear. One patient developed paraparesis while other patient had high LDH levels. The clinical diagnosis of TTP and TAMOF was made respectively. Both patients were treated with plasmapharesis and renal replacement therapy. Both gradually improved and were discharged.
Department of Pediatrics and Child Health, The Aga Khan University Hospital, Karachi, Pakistan. rehan.khan@aku.edu
Muhammad Rehan
MR
Khan
Prem Kumar
PK
Maheshwari
Anwarul
A
Haque
D000293:Adolescent; D016883:Diabetic Ketoacidosis / Q000150:complications*; D005260:Female; D006801:Humans; D011697:Purpura, Thrombotic Thrombocytopenic / Q000209:etiology*