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一名新诊断糖尿病儿童发生酮症酸中毒并发弥散性血管内凝血和严重周围神经病变。

Disseminated intravascular coagulation and severe peripheral neuropathy complicating ketoacidosis in a newly diagnosed diabetic child.

作者信息

Bonfanti R, Bognetti E, Meschi F, Medaglini S, D'Angelo A, Chiumello G

出版信息

Acta Diabetol. 1994 Sep;31(3):173-4. doi: 10.1007/BF00570376.

Abstract

Disseminated intravascular coagulation is a very rare complication of diabetic ketoacidosis. Central nervous system palsy but not peripheral neuropathy has been reported in these patients. On the other hand, signs of peripheral neuropathy may also be present at the onset of diabetes, but they are usually reversible within a few days after correction of the metabolic derangement. We describe an unusual case of mononeuritis multiplex syndrome still present after 2 months of follow-up in a child with diabetic ketoacidosis complicated by disseminated intravascular coagulation at the onset of insulin-dependent diabetes. These neurological impairments may be consistent with functional neural lesions due to vasa nervorum thrombosis and prolonged ischaemia.

摘要

弥散性血管内凝血是糖尿病酮症酸中毒一种非常罕见的并发症。这些患者曾有中枢神经系统麻痹的报道,但未出现周围神经病变。另一方面,周围神经病变的体征在糖尿病发病时也可能存在,但通常在代谢紊乱纠正后的几天内可逆转。我们描述了一例不寻常的多发性单神经炎综合征病例,该病例发生在一名胰岛素依赖型糖尿病初发时合并弥散性血管内凝血的儿童身上,随访2个月后仍存在。这些神经功能障碍可能与神经滋养血管血栓形成和长期缺血导致的功能性神经损伤一致。

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