Suzuki Junichi, Fuchigami Tatsuo, Kawamura Kengo, Aoki Masako, Urakami Tatsuhiko, Morioka Ichiro
Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan.
J Pediatr Endocrinol Metab. 2019 Dec 18;32(12):1391-1394. doi: 10.1515/jpem-2019-0233.
Background Diabetic ketoacidosis (DKA) is a common complication of type 1 diabetes mellitus (T1DM). Infants and children with new-onset T1DM may present with DKA, and the risk of cerebral edema is high in infantile DKA. What is new? Neurological deterioration during an episode of DKA is usually attributed to cerebral edema and cerebrovascular accidents. However, cerebral infarction is a very rare complication in infantile DKA. Case presentation We describe a rare case of infantile cerebral infarction caused by severe DKA in a patient with new-onset T1DM. Conclusions Cerebral infarction is an important intracranial complication in infantile DKA. Careful observation and treatment for DKA during the first 24 h of therapy are necessary in infants with new-onset T1DM because the risk of cerebral infarction is highest during this timeframe.
背景 糖尿病酮症酸中毒（DKA）是1型糖尿病（T1DM）的常见并发症。新诊断T1DM的婴幼儿可能会出现DKA，且婴幼儿DKA发生脑水肿的风险较高。新情况是什么？DKA发作期间的神经功能恶化通常归因于脑水肿和脑血管意外。然而，脑梗死在婴幼儿DKA中是一种非常罕见的并发症。病例报告 我们描述了1例新诊断T1DM患者因严重DKA导致婴幼儿脑梗死的罕见病例。结论 脑梗死是婴幼儿DKA的一种重要颅内并发症。新诊断T1DM的婴幼儿在治疗的头24小时内必须对DKA进行仔细观察和治疗，因为在此时间段内脑梗死风险最高。
