Hypoxic hepatitis as a complication of newly diagnosed type 1 diabetes in a teenager
Hypoxic hepatitis is a rare complication of type 1 diabetes with unknown prevalence in Pediatrics. We present a case report of an 11-year-old boy admitted to the ER in the spring of 2020 (the beginning of the COVID19 pandemic in Poland) due to nausea, abdominal pain, and weight loss. A diagnosis of...
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| Format: | Article |
| Language: | English |
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University of São Paulo
2022-06-01
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| Series: | Autopsy and Case Reports |
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| Online Access: | https://www.revistas.usp.br/autopsy/article/view/199103 |
| _version_ | 1828315190239690752 |
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| author | Kamil Buczkowski Irena Ożóg-Zabolska Jacek Gulczyński Ewa Iżycka-Świeszewska |
| author_facet | Kamil Buczkowski Irena Ożóg-Zabolska Jacek Gulczyński Ewa Iżycka-Świeszewska |
| author_sort | Kamil Buczkowski |
| collection | DOAJ |
| description |
Hypoxic hepatitis is a rare complication of type 1 diabetes with unknown prevalence in Pediatrics. We present a case report of an 11-year-old boy admitted to the ER in the spring of 2020 (the beginning of the COVID19 pandemic in Poland) due to nausea, abdominal pain, and weight loss. A diagnosis of type 1 diabetes accompanied by severe ketoacidosis (pH 6.9, blood glucose 632mg/dl, ketone bodies in urine – 150mg/dl) was made. The hyperglycemia, ketoacidosis, and water-electrolyte disturbances were treated in the Pediatric Intensive Care Unit. On day 4, the boy developed fulminant septic shock with high aminotransferases (AST 9026 U/l, ALT 3559 U/l). CT scan revealed hepatic enlargement and steatosis. Acute viral hepatitis was suspected. The levels of anti-CMV IgM and IgG antibodies were slightly elevated. At autopsy, the liver was enlarged, with petechial bleedings on the surface. The liver parenchyma was congested, with signs of steatosis. Microscopically, there was extensive centrilobular necrosis, acute passive sinusoidal congestion, and steatosis of hepatocytes. There were no signs of CMV infection. Based on the entire clinicopathological picture, the patient was diagnosed with hypoxic hepatitis, complicated by septic shock and multiple organ failure.
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| first_indexed | 2024-04-13T16:56:39Z |
| format | Article |
| id | doaj.art-347c1943834f4486afd6e857eee78014 |
| institution | Directory Open Access Journal |
| issn | 2236-1960 |
| language | English |
| last_indexed | 2024-04-13T16:56:39Z |
| publishDate | 2022-06-01 |
| publisher | University of São Paulo |
| record_format | Article |
| series | Autopsy and Case Reports |
| spelling | doaj.art-347c1943834f4486afd6e857eee780142022-12-22T02:38:47ZengUniversity of São PauloAutopsy and Case Reports2236-19602022-06-0112Hypoxic hepatitis as a complication of newly diagnosed type 1 diabetes in a teenagerKamil Buczkowski0 Irena Ożóg-Zabolska1Jacek Gulczyński2Ewa Iżycka-Świeszewska3Szpital im. Mikołaja Kopernika (COPERNICUS PL), Department of Pathomorphology, Gdansk, Poland / Gdański Uniwersytet Medyczny (GUMed), Department of Pathology and Neuropathology, Gdansk, PolandSzpital im. Mikołaja Kopernika (COPERNICUS PL), Pediatric Intensive Care Unit, Gdansk, PolandGdański Uniwersytet Medyczny (GUMed), Department of Pathology and Neuropathology, Gdansk, PolandSzpital im. Mikołaja Kopernika (COPERNICUS PL), Department of Pathomorphology, Gdansk, Poland / Gdański Uniwersytet Medyczny (GUMed), Department of Pathology and Neuropathology, Gdansk, Poland Hypoxic hepatitis is a rare complication of type 1 diabetes with unknown prevalence in Pediatrics. We present a case report of an 11-year-old boy admitted to the ER in the spring of 2020 (the beginning of the COVID19 pandemic in Poland) due to nausea, abdominal pain, and weight loss. A diagnosis of type 1 diabetes accompanied by severe ketoacidosis (pH 6.9, blood glucose 632mg/dl, ketone bodies in urine – 150mg/dl) was made. The hyperglycemia, ketoacidosis, and water-electrolyte disturbances were treated in the Pediatric Intensive Care Unit. On day 4, the boy developed fulminant septic shock with high aminotransferases (AST 9026 U/l, ALT 3559 U/l). CT scan revealed hepatic enlargement and steatosis. Acute viral hepatitis was suspected. The levels of anti-CMV IgM and IgG antibodies were slightly elevated. At autopsy, the liver was enlarged, with petechial bleedings on the surface. The liver parenchyma was congested, with signs of steatosis. Microscopically, there was extensive centrilobular necrosis, acute passive sinusoidal congestion, and steatosis of hepatocytes. There were no signs of CMV infection. Based on the entire clinicopathological picture, the patient was diagnosed with hypoxic hepatitis, complicated by septic shock and multiple organ failure. https://www.revistas.usp.br/autopsy/article/view/199103HepatitisGastroenterologyPediatricsDiabetes MellitusAutopsy |
| spellingShingle | Kamil Buczkowski Irena Ożóg-Zabolska Jacek Gulczyński Ewa Iżycka-Świeszewska Hypoxic hepatitis as a complication of newly diagnosed type 1 diabetes in a teenager Autopsy and Case Reports Hepatitis Gastroenterology Pediatrics Diabetes Mellitus Autopsy |
| title | Hypoxic hepatitis as a complication of newly diagnosed type 1 diabetes in a teenager |
| title_full | Hypoxic hepatitis as a complication of newly diagnosed type 1 diabetes in a teenager |
| title_fullStr | Hypoxic hepatitis as a complication of newly diagnosed type 1 diabetes in a teenager |
| title_full_unstemmed | Hypoxic hepatitis as a complication of newly diagnosed type 1 diabetes in a teenager |
| title_short | Hypoxic hepatitis as a complication of newly diagnosed type 1 diabetes in a teenager |
| title_sort | hypoxic hepatitis as a complication of newly diagnosed type 1 diabetes in a teenager |
| topic | Hepatitis Gastroenterology Pediatrics Diabetes Mellitus Autopsy |
| url | https://www.revistas.usp.br/autopsy/article/view/199103 |
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