Rhabdomyolysis Due to Severe Hypophosphatemia in Diabetic Ketoacidosis
Rhabdomyolysis(RM) is a syndrome characterized by injury to skeletal muscle fibers with disruption and release of toxic metabolites into circulation. It is characterized by triad of muscle weakness, myalgia and dark urine and is associated with increased creatine kinase (CK) and lactate dehydrogenas...
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2015-06-01
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doaj-9dc5fabd8c36453fa1921ff04264d5682020-11-24T22:36:06ZengNepal Medical AssociationJournal of Nepal Medical Association0028-27151815-672X2015-06-01531981371402777Rhabdomyolysis Due to Severe Hypophosphatemia in Diabetic KetoacidosisSatish Kumar Shah0Lokraj Shah1Suraj Bhattarai2Megha Giri3B.P. Koirala Institute of Health Sciences, Dharan, Nepal.B.P. Koirala Institute of Health Sciences, Dharan, Nepal.B.P. Koirala Institute of Health Sciences, Dharan, Nepal.B.P. Koirala Institute of Health Sciences, Dharan, Nepal.Rhabdomyolysis(RM) is a syndrome characterized by injury to skeletal muscle fibers with disruption and release of toxic metabolites into circulation. It is characterized by triad of muscle weakness, myalgia and dark urine and is associated with increased creatine kinase (CK) and lactate dehydrogenase (LDH). A severely malnourished 10 year old girl with severe diabetic ketoacidosis (DKA) as hemr initial presentation of type 1 diabetes mellitus developed rhabdomyolysis (CK- 12,000 U/L) with nonoliguric renal failure during her initial course of hospital stay. The possible cause of her RM was attributed to severe hypophosphatemia (minimum serum phosphate, 0.8 mg/dL). Management of DKA, phosphate supplementation and urinary alkalinization with diuresis improved her clinical course. She was discharged on Day 9 with Insulin. We recommend frequent monitoring of serum phosphate during early period of DKA, particularly in malnourished children, and its normalization in case of severe hypophosphatemia. Keywords: diabetic ketoacidosis; hypophosphatemia; malnutrition; renal failure; rhabdomyolysis.http://jnma.com.np/jnma/index.php/jnma/article/view/2777 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Satish Kumar Shah Lokraj Shah Suraj Bhattarai Megha Giri |
spellingShingle |
Satish Kumar Shah Lokraj Shah Suraj Bhattarai Megha Giri Rhabdomyolysis Due to Severe Hypophosphatemia in Diabetic Ketoacidosis Journal of Nepal Medical Association |
author_facet |
Satish Kumar Shah Lokraj Shah Suraj Bhattarai Megha Giri |
author_sort |
Satish Kumar Shah |
title |
Rhabdomyolysis Due to Severe Hypophosphatemia in Diabetic Ketoacidosis |
title_short |
Rhabdomyolysis Due to Severe Hypophosphatemia in Diabetic Ketoacidosis |
title_full |
Rhabdomyolysis Due to Severe Hypophosphatemia in Diabetic Ketoacidosis |
title_fullStr |
Rhabdomyolysis Due to Severe Hypophosphatemia in Diabetic Ketoacidosis |
title_full_unstemmed |
Rhabdomyolysis Due to Severe Hypophosphatemia in Diabetic Ketoacidosis |
title_sort |
rhabdomyolysis due to severe hypophosphatemia in diabetic ketoacidosis |
publisher |
Nepal Medical Association |
series |
Journal of Nepal Medical Association |
issn |
0028-2715 1815-672X |
publishDate |
2015-06-01 |
description |
Rhabdomyolysis(RM) is a syndrome characterized by injury to skeletal muscle fibers with disruption and release of toxic metabolites into circulation. It is characterized by triad of muscle weakness, myalgia and dark urine and is associated with increased creatine kinase (CK) and lactate dehydrogenase (LDH). A severely malnourished 10 year old girl with severe diabetic ketoacidosis (DKA) as hemr initial presentation of type 1 diabetes mellitus developed rhabdomyolysis (CK- 12,000 U/L) with nonoliguric renal failure during her initial course of hospital stay. The possible cause of her RM was attributed to severe hypophosphatemia (minimum serum phosphate, 0.8 mg/dL). Management of DKA, phosphate supplementation and urinary alkalinization with diuresis improved her clinical course. She was discharged on Day 9 with Insulin. We recommend frequent monitoring of serum phosphate during early period of DKA, particularly in malnourished children, and its normalization in case of severe hypophosphatemia.
Keywords: diabetic ketoacidosis; hypophosphatemia; malnutrition; renal failure; rhabdomyolysis. |
url |
http://jnma.com.np/jnma/index.php/jnma/article/view/2777 |
work_keys_str_mv |
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