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低磷血症:儿童 DKA 并发心脏功能障碍的常见但易被忽视的病因。

Hypophosphatemia: A Common but Overlooked Cause of Cardiac Dysfunction in a Child with DKA.

机构信息

Division of Pediatric Emergency and Intensive Care Units, Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.

Department of Pediatrics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

出版信息

Indian J Pediatr. 2024 Apr;91(4):401-403. doi: 10.1007/s12098-023-04488-x. Epub 2023 Mar 1.

Abstract

Diabetic ketoacidosis in children is associated with a wide gamut of complications, which can be either disease- or therapy-related. Common complications in children with DKA include cerebral edema, acute kidney injury, hypokalemia, hypoglycemia, etc. As opposed to asymptomatic hypophosphatemia, which is common during the management of DKA, severe symptomatic hypophosphatemia leading to life-threatening complications like rhabdomyolysis, hemolysis, respiratory failure secondary to muscle weakness, and cardiac complications are rare. The authors present a case of a newly diagnosed T1DM patient who, during the course of management, developed severe hypophosphatemia leading to arrhythmias and cardiac dysfunction, which improved with prompt recognition and correction.

摘要

儿童糖尿病酮症酸中毒与广泛的并发症相关,这些并发症可能与疾病或治疗有关。患有 DKA 的儿童常见的并发症包括脑水肿、急性肾损伤、低钾血症、低血糖等。与 DKA 治疗期间常见的无症状性低磷血症不同,严重的有症状性低磷血症可导致危及生命的并发症,如横纹肌溶解症、溶血性贫血、肌肉无力引起的呼吸衰竭和心脏并发症,较为罕见。作者报告了一例新诊断的 1 型糖尿病患者,在治疗过程中发生严重低磷血症,导致心律失常和心功能障碍,经及时识别和纠正后得到改善。

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