Can we effectively predict the occurrence of cerebral edema in children with ketoacidosis in the course of type 1 diabetes? - case report and literature review

J Pediatr Endocrinol Metab. 2020 Feb 25;33(2):319-322. doi: 10.1515/jpem-2019-0440.

Abstract

Background Cerebral edema (CE) is one of the most serious complications of diabetic ketoacidosis (DKA) and can result in central nervous system (CNS) disorders and even lead to death of the patient. Case presentation We present the case of a 11-year-old boy with severe DKA in the course of newly diagnosed type 1 diabetes (T1D). The delay in the diagnosis of DKA and some therapeutic problems contributed to the development of CE and direct life-threatening conditions. Early diagnosis of CE development in the course of DKA using non-invasive methods such as pachymetry or transorbital ultrasound seems to be a very important prognostic factor. Conclusions This case highlights the importance of appropriate treatment according to the newest recommendations and presents the usefulness of new diagnostic methods to assess the risk of CE in children with newly diagnosed T1D.

Keywords: cerebral edema; optic nerve sheath diameter; type 1 diabetes.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Brain Edema / diagnosis
  • Brain Edema / etiology*
  • Brain Edema / therapy
  • Child
  • Delayed Diagnosis / adverse effects*
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetic Ketoacidosis / complications*
  • Diabetic Ketoacidosis / pathology
  • Humans
  • Male
  • Prognosis
  • Risk Factors