Organophosphorus poisoning presenting as diabetic ketoacidosis.
نویسندگان
چکیده
74 VOLUME 48__JANUARY 17, 2011 A 12 year old male was brought to us with history of fatiguability, vomiting and loose stools for 6 hours. There was no history of fever, convulsion, and altered sensorium. The vitals were stable except some dehydration. Investigations revealed hemoglobin 10.8g/dL, TLC 16.6×103/mL, platelet 360×103/mL, blood sugar 299g/dL, blood urea 28g/ dL, S creatinine 0.9g/dL, Na 139 mEq/L,K 3.3mEq/ L, pH 7.38, PaCO2 32 mmHg, PaO2 96 mmHg, and Bicarbonate 19 mEq/L. Urine showed sugar 4+ and moderate ketone bodies. In view of dehydration, hyperglycemia, glycosuria, ketonuria, low bicarbonate levels, DKA treatment protocol was started with IV fluids and insulin infusion. The level of consiousness deteriorated by 12 hours and Glasgow Coma Scale was 12. He developed fasiculations and jerky movement of limbs. His respiration was 28/min and shallow, heart rate 64/ min, BP 110/70 mm of Hg, oxygen saturation 96%. His pupils were 2mm in size and were reactive. CT scan head was normal. Due to fasiculations and shallow respiration, organophosphorus intoxication was suspected and plasma cholinesterase was done; it was 550 U/L (Normal=2710-11510 U/L). The diagnosis was revised to organophosphorus intoxication and child was managed with atropine and pralidoxime. He responded well and was discharged after 6 days. Retrospectively, boy gave history of ingestion of 4 tomatoes in the field without washing 6 hours prior to admission.
منابع مشابه
Organophosphorus poisoning presentating as diabetic ketoacidosis: a real challenge for the endocrinologist.
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عنوان ژورنال:
- Indian pediatrics
دوره 48 1 شماره
صفحات -
تاریخ انتشار 2011