Journal of Clinical Sciences

CASE REPORT
Year
: 2022  |  Volume : 19  |  Issue : 4  |  Page : 142--145

Rhabdomyolysis: A rare and often-missed complication of diabetic ketoacidosis


Khadijah Omobusola Oleolo-Ayodeji1, Helen Olubunmi Salako1, Olaolu Aziza Moronkola1, Elizabeth Eberechi Oyenusi2, Abiola Olufunmilayo Oduwole2 
1 Department of Paediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
2 Department of Paediatrics, Endocrinology and Metabolism Unit, College of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria

Correspondence Address:
Dr. Elizabeth Eberechi Oyenusi
Department of Paediatrics, Endocrinology and Metabolism Unit, College of Medicine, Lagos University Teaching Hospital, Lagos
Nigeria

A 19-year-old male with type 1 diabetes mellitus (diagnosed at 12 years of age) was brought to the emergency room with fever and altered sensorium. His compliance with his insulin regimen was questionable. Examination revealed a Glasgow Coma Scale of 5/15, sluggishly-reacting pupils, severe dehydration, and fever (temperature 38.8°C). Vital signs at the upper limit of normal, urethral catheter drained dark red urine with output of 1–2 ml/kg/hr. Laboratory investigations showed hyperglycemia (250 mg/dL), ketonuria (+) hematuria (+++) and proteinuria (++), and glycated hemoglobin (HbA1C) – 9.6%. Full blood count showed leukopenia, neutrophilia, and thrombocytopenia. Deranged electrolytes included hypernatremia, metabolic acidosis, and hypophosphatemia with elevated urea and blood urea nitrogen. Serum creatinine kinase (CK) was elevated. A diagnosis of diabetic ketoacidosis (DKA) with rhabdomyolysis (RM) and raised intracranial pressure was made and he was managed with adequate fluid resuscitation, osmotic diuresis, glycemic control, platelet transfusion, and antibiotics with clinical improvement. Normal CK levels were documented 3 months later. RM is a rare complication of DKA. High index of suspicion should be maintained for prompt detection and management to prevent potential complications, especially acute kidney injury.


How to cite this article:
Oleolo-Ayodeji KO, Salako HO, Moronkola OA, Oyenusi EE, Oduwole AO. Rhabdomyolysis: A rare and often-missed complication of diabetic ketoacidosis.J Clin Sci 2022;19:142-145


How to cite this URL:
Oleolo-Ayodeji KO, Salako HO, Moronkola OA, Oyenusi EE, Oduwole AO. Rhabdomyolysis: A rare and often-missed complication of diabetic ketoacidosis. J Clin Sci [serial online] 2022 [cited 2023 Jan 29 ];19:142-145
Available from: https://www.jcsjournal.org/article.asp?issn=2468-6859;year=2022;volume=19;issue=4;spage=142;epage=145;aulast=Oleolo-Ayodeji;type=0