Acute hypoxic hepatopathy: diabetic ketoacidosis complication in an infant newly diagnosed with type 1 diabetes mellitus

Abstract

Aim of the study: Case presentation of hepatic dysfunction after severe ketoacidosis in an infant newly diagnosed with type 1 diabetes mellitus.

Material and methods: A 10-month old Caucasian boy has been admitted to the hospital with pH 6.85, body temperature of 39.9 degrees C and plasma glucose 145 mmol/l. The patient was diagnosed with type 1 diabetes mellitus complicated by diabetic ketoacidosis and otitis media. During the next 48 hours of treatment glucose level and acidosis have normalized. On the 3 day, laboratory tests showed a rapid increase in AST and ALT levels to 8000 IU/L and 6000 IU/L, respectively; INR=2.9. A gradual decrease of transaminase level was observed on the 5 day, while during the next weeks all liver function tests normalized. The patient was recognized with ischemic hepatitis based on abnormal biochemical tests and exclusion of viral infection and hepatotoxic agents.

Conclusions: Diabetic ketoacidosis complicated by hypovolemic shock, infection and profound metabolic decompensation may lead to hypoxic hepatopathy in infants.