The Turkish Journal of Pediatrics 2017 , Vol 59 , Num 3
Alpha coma in an adolescent with diabetic ketoacidosis
Slavica Ostojic 1 ,Rade Vukovic 2 ,Tatjana Milenkovic 2 ,Katarina Mitrovic 2 ,Milena Djuric 3 ,Ljubica Nikolic 4
1 Department of Neurology, Mother and Child Health Care Institute of Serbia “Dr Vukan Cupic”, Belgrade, Serbia
2 Department of Endocrinology, Mother and Child Health Care Institute of Serbia “Dr Vukan Cupic”, Belgrade, Serbia
3 School of Medicine, University of Belgrade, Serbia
4 Intensive Care Unit, Mother and Child Health Care Institute of Serbia “Dr. Vukan Cupic”, Belgrade, Serbia
DOI : 10.24953/turkjped.2017.03.014 Ostojic S, Vukovic R, Milenkovic T, Mitrovic K, Djuric M, Nikolic L. Alpha coma in an adolescent with diabetic ketoacidosis. Turk J Pediatr 2017; 59: 318-321.

This is the first report of alpha coma (AC) caused by brain edema in a patient with diabetic ketoacidosis (DKA). A previously healthy 15-year-old girl was admitted to the intensive care unit due to altered state of consciousness during the course of treatment for DKA. Patient was in a coma, intubated and had tachycardia with poor peripheral perfusion. Results of laboratory analyses indicated severe DKA and computed tomography scan indicated diffuse brain edema. The EEG pattern showed uniform alpha activity. Treatment with intravenous fluids, insulin and mannitol was started. Patient`s state of consciousness gradually improved and on the third day she was extubated. On the fifth day, her neurologic status and EEG findings were completely normal with no residual neurological deficits. In conclusion, although AC is associated with a high fatality rate, favorable outcome can be achieved with prompt recognition and treatment of cerebral edema in pediatric patients with DKA. Keywords : alpha coma, brain edema, diabetic ketoacidosis, type 1 diabetes mellitus, outcome

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