Document Detail


A possible hypophosphatemia-induced, life-threatening encephalopathy in diabetic ketoacidosis: a case report.
MedLine Citation:
PMID:  17570993     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hypophosphatemia, a common metabolic disorder, is usually silent and diagnosed by blood tests. However, misdiagnosis may result in delayed phosphate repletion, responsible for significant morbidity and potential mortality. We report an exceptional case of hypophosphatemia-related, life-threatening encephalopathy. A 49-year-old type-1 diabetic woman was admitted to our intensive care unit with coma and severe ketoacidosis. Initial neurologic impairment worsened despite improvement in acid-base disturbances and glucose levels. The electroencephalogram showed bilateral spikes with a background theta wave rhythm. Profound hypophosphatemia <0.20 mmol/L (<0.6 mg/dL) was diagnosed. No other cause of encephalopathy was found. Prompt phosphate repletion resulted in progressive and complete recovery. This observation allowed us to study the relations between the coma depth, the electroencephalographic findings, and the serum phosphate concentrations. Our data strongly suggest that phosphate depletion-induced encephalopathy probably originates from direct impairment of cerebral electrophysiological activity rather than from cardiac flow alteration.
Authors:
Bruno Mégarbane; Gilles Guerrier; Anne Blancher; Taly Meas; Pierre-Jean Guillausseau; Frederic J Baud
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  333     ISSN:  0002-9629     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-15     Completed Date:  2007-08-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  384-6     Citation Subset:  AIM; IM    
Affiliation:
Medical Critical Care Department, Lariboisière Hospital, Paris, France. bruno-megarbane@wanadoo.fr
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MeSH Terms
Descriptor/Qualifier:
Brain Diseases, Metabolic* / etiology,  physiopathology,  therapy
Diabetes Mellitus, Type 1
Diabetic Ketoacidosis / complications*,  diagnosis,  therapy
Electroencephalography
Female
Humans
Hypophosphatemia* / complications,  diagnosis,  therapy
Middle Aged
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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