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New‐onset diabetes mellitus presenting with diabetic ketoacidosis after pediatric liver transplantation
Author(s) -
Dehghani Seyed Mohsen,
Nikeghbalian Saman,
Eshraghian Ahad,
Haghighat Mahmood,
Imanieh Mohammad Hadi,
Bahador Ali,
Kazemi Kourosh,
MalekHosseini Seyed Ali
Publication year - 2009
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2008.01117.x
Subject(s) - medicine , liver transplantation , diabetic ketoacidosis , diabetes mellitus , tacrolimus , transplantation , sepsis , complication , cirrhosis , liver disease , metabolic acidosis , surgery , endocrinology
The development of NODM is a common metabolic complication after liver transplantation. Presentation of post‐liver transplant diabetes mellitus with DKA is rare especially among pediatric patients. We reported three pediatric patients who presented with DKA after liver transplantation. The underlying diseases leading to transplantation were cryptogenic liver cirrhosis, Wilson disease, and congenital hepatic fibrosis. None of the three patients had a history of diabetes prior to transplantation and all of them were cases of NODM after transplantation. All three patients presented with severe hyperglycemia, significant ketosis, and metabolic acidosis of variable severity. All of them received tacrolimus as one of the immunosuppressant agents. The patients received a liver transplant from a DD. The patients were treated with intravenous insulin injection (0.1 U/kg/h) and recovered from DKA, but one case expired in the intensive care unit because of bacterial sepsis after recovery from DKA. Our experience suggests that PTDM may result in ketoacidosis, and we emphasize the importance of paying more attention to glucose metabolism and risk of diabetes mellitus in patients with immunosuppressive therapy, especially tacrolimus.