Coma With Diffuse White Matter Hemorrhages in Juvenile Diabetic Ketoacidosis

Cerebral edema is the most common neurologic complication of diabetic ketoacidosis in children. A minority of young patients with intracerebral crises in diabetic ketoacidosis present with cerebrovascular accidents. We report 2 adolescent patients with diabetic ketoacidosis who presented with coma a...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2007-12, Vol.120 (6), p.e1540-e1546
Main Authors: Mahmud, Farid H, Ramsay, David A, Levin, Simon D, Singh, Ram N, Kotylak, Trevor, Fraser, Douglas D
Format: Article
Language:English
Subjects:
Accidents
Adolescent
Child
Children & youth
Coma
Coma - etiology
Diabetic Ketoacidosis - complications
Diabetic neuropathy
Fatal Outcome
Female
Hemorrhage
Humans
Intracranial Hemorrhages - etiology
Pathology
Pediatrics
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Summary:Cerebral edema is the most common neurologic complication of diabetic ketoacidosis in children. A minority of young patients with intracerebral crises in diabetic ketoacidosis present with cerebrovascular accidents. We report 2 adolescent patients with diabetic ketoacidosis who presented with coma and diffuse white matter hemorrhages in the absence of either cerebral edema or cerebrovascular accidents. These 2 cases illustrate a novel clinical and neuropathologic description of diffuse white matter hemorrhages, possibly related to a cytotoxic process as the underlying mechanism. These case descriptions emphasize that pediatric patients with diabetic ketoacidosis and coma can present with pathology not related to either cerebral edema or cerebrovascular accidents.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.2007-0366