Hypertension Despite Dehydration in an Adolescent with Diabetic Ketoacidosis
A 17-year-old girl presented in our Children’s Emergency Unit with complaints of excessive eating for 6 weeks, excessive urination for 2 weeks, fever for 1 week, vomiting for 4 days, difficulty with breathing for one day and unresponsiveness to calls for 3 hours. She had moderated to severe dehydration but no hypotension. Laboratory findings included hyperglycaemia (random blood glucose 20.8 mmo/L; 347 mg/dl), acidosis (serum bicarbonate 5 mmol/L), ketonuria 2+; glycosuria 2+, and urine specific gravity of 1.015. At admission, the blood pressure was 100/60 mmHg but progressively rose to 140-180/80-100 mmHg by the third day from admission. A significant hypertension can occur in children and adolescents admitted for severe DKA despite the presence of dehydration. Therefore, the attending physician should be aware of this possibility.
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