Ketoacidosis as a presenting symptom of diabetes in a eighteen month old infant: a case report

Authors

  • Amrita Mohan Department of Paediatrics, Vithal Children’s Hospital and Institute of Child Health, Dharwad, Karnataka, India
  • Sunkad M. A. Department of Community Medicine, USM-KLE-International Medical Program, Belgaum, Karnataka, India
  • Javali S. B. Department of Community Medicine, USM-KLE-International Medical Program, Belgaum, Karnataka, India
  • Sowmya Vernekar Department of Paediatrics, USM-KLE-International Medical Program, Belgaum, Karnataka, India
  • Shilpa Hidakal Department of Community Medicine, USM-KLE-International Medical Program, Belgaum, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20201157

Keywords:

Air hunger, Challenges, Difficulties, Random blood sugar

Abstract

There is a world-wide trend in rise of diabetes cases. There is also rise in the trend of any one person getting diabetes at an early age. However, diabetes is fairly less common in children less than 5 years. The manifestation of diabetes too can be peculiar in very young children. Then managed as per standard protocol, results can be rewarding. Ours is secondary healthcare facility with all diagnostic equipment and consultants available round the clock. Authors describe one case finding of diabetic ketoacidosis. The baby aged 18 months presented with cold, cough, fever and air hunger (breathing deeply), referred by family doctor. The prompt diagnosis, rehydration, insulin infusion helped in recovery. Complete blood tests confirmed the presence of random blood sugar 345mg%, pH 7.05, Ketone bodies present in urine. While there was Leukocytosis, tests for Dengue Fever and Typhoid were negative.

Identification of ketoacidosis and prompt treatment can save children.

References

Prasad D, Awasthi S. A retrospective case study of clinical profile of hospitalized children with type 1 diabetes mellitus at a tertiary health care center in northern India. Clin Epidemiol Global Heal. 2013 Dec 1;1(3):137-41.

Varadarajan P, Sangaralingam T, Senniappan S, Jahnavi S, Radha V, Mohan V. Clinical profile and outcome of infantile onset diabetes mellitus in southern India. Ind Pediatr. 2013 Aug 1;50(8):759-63.

Sunkad MA, Javali SB, Sulikeri PN, Rajendra A. A cross sectional study of Screening for hypertension, diabetes and connectivity in the rural population of North Karnataka, India. Int J Res Health Allied Sci 2018;4(4):17-22.

Huang K, Liang L, Fu JF, Dong GP. Permanent neonatal diabetes mellitus in China. BMC Pediatr. 2014 Dec 1;14(1):188.

Arce KM, Pantalone KM. Not all diabetes in infants is type 1: a case report. Diabetes Therapy. 2016 Jun 1;7(2):369-75.

Kumar KM. Incidence trends for childhood type 1 diabetes in India. Ind J Endocrinol Metabolism. 2015 Apr;19(Suppl 1):S34.

Akinola IJ, Odusote OA, Oduwole AO. Neonatal Diabetic Ketoacidosis in a Nigerian Infant: A Case Report. Nig Q J Hosp Med. 2015 Apr-Jun;25(2):139-41.

Sood S, Landreth H, Bustinza J, Chalmers L, Thukaram R. Neonatal diabetes: case report of a 9-week-old presenting diabetic Ketoacidosis Due to an activating ABCC8 gene mutation. J Invest Medic High Impact Case Rep. 2017 Mar;5(1): 2324709617698718.

Fredrick F, Sawe H, Muze K, Mally D, Majaliwa E. A seven weeks old baby with diabetic ketoacidosis: a case report. Clin Case Reports. 2016 Feb;4(2):147-50.

Sharma D, Kuppusamy K, Bhoorasamy A. Prevalence of acute respiratory infections (ARI) and their determinants in under five children in urban and rural areas of Kancheepuram district, South India. Ann Trop Medic Public Health. 2013 Sep 1;6(5):513-8.

Walke SP, Das R, Acharya AS, Pemde HK. Incidence, pattern, and severity of acute respiratory infections among infants and toddlers of a peri-urban area of Delhi: a 12-month prospective study. Inter Scholarly Resea Notice. 2014;2014.

Mohanraj R, Kumar S, Jayakumar S, Agarwal M, Dhingra B, Jeyaseelan V, et al. Where do mothers take their children for pneumonia care? Findings from three Indian states. PloS one. 2019;14(4).

Ramani VK, Pattankar J, Puttahonnappa SK. Acute respiratory infections among under-five age group children at urban slums of gulbarga city: A longitudinal study. J Clin Diagn Research: JCDR. 2016 May;10(5):LC08.

Jayashree M, Sasidharan R, Singhi S, Nallasamy K, Baalaaji M. Root cause analysis of diabetic ketoacidosis admissions at a tertiary referral pediatric emergency department in North India. Ind J Endocrinol Metabol. 2017 Sep;21(5):710-4.

Katte JC, Djoumessi R, Njindam G, Fetse GT, Dehayem M, Kengne AP. New-onset diabetic ketoacidosis in a 13-months old african toddler: a case report. Pan African Med J. 2015;22(1)293.

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Published

2020-03-21

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Section

Case Reports