Ostojic Slavica, Vukovic Rade, Milenkovic Tatjana, Mitrovic Katarina, Djuric Milena, Nikolic Ljubica
Department of Neurology, Mother and Child Health Care Institute of Serbia "Dr Vukan Cupic", Belgrade, Serbia.
Department of Endocrinology, Mother and Child Health Care Institute of Serbia "Dr Vukan Cupic", Belgrade, Serbia.
Turk J Pediatr. 2017;59(3):318-321. doi: 10.24953/turkjped.2017.03.014.
Ostojic S, Vukovic R, Milenkovic T, Mitrovic K, Djuric M, Nikolic L. Alpha coma in an adolescent with diabetic ketoacidosis. Turk J Pediatr 2017; 59: 318-321. This is the first report of alpha coma (AC) caused by brain edema in a patient with diabetic ketoacidosis (DKA). A previously healthy 15-year-old girl was admitted to the intensive care unit due to altered state of consciousness during the course of treatment for DKA. Patient was in a coma, intubated and had tachycardia with poor peripheral perfusion. Results of laboratory analyses indicated severe DKA and computed tomography scan indicated diffuse brain edema. The EEG pattern showed uniform alpha activity. Treatment with intravenous fluids, insulin and mannitol was started. Patient`s state of consciousness gradually improved and on the third day she was extubated. On the fifth day, her neurologic status and EEG findings were completely normal with no residual neurological deficits. In conclusion, although AC is associated with a high fatality rate, favorable outcome can be achieved with prompt recognition and treatment of cerebral edema in pediatric patients with DKA.
奥斯特约伊奇 S、武科维奇 R、米伦科维奇 T、米特罗维奇 K、久里契奇 M、尼科利奇 L。一名患有糖尿病酮症酸中毒的青少年出现α昏迷。《土耳其儿科学杂志》2017 年；59: 318 - 321。这是关于糖尿病酮症酸中毒（DKA）患者因脑水肿导致α昏迷（AC）的首例报告。一名此前健康的 15 岁女孩在 DKA 治疗过程中因意识状态改变被收入重症监护病房。患者处于昏迷状态，已插管，有心动过速且外周灌注不良。实验室分析结果显示严重 DKA，计算机断层扫描显示弥漫性脑水肿。脑电图模式显示均匀的α活动。开始给予静脉补液、胰岛素和甘露醇治疗。患者的意识状态逐渐改善，第三天拔管。第五天，她的神经状态和脑电图结果完全正常，无残留神经功能缺损。总之，尽管α昏迷与高死亡率相关，但对于患有 DKA 的儿科患者，通过及时识别和治疗脑水肿可取得良好预后。
