Urinary stone in a 12-year-old adolescent with new-onset type 1 diabetes and diabetic ketoacidosis.

Autor: Ushijima-Fuchino K; Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan., Koga Y; Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan., Umino S; Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan., Nishioka J; Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan., Araki J; Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan., Yatsuga S; Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan.; Department of Pediatrics, Fukuoka University Faculty of Medicine, Fukuoka, Japan., Yamashita Y; Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan.
Jazyk: angličtina
Zdroj: Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology [Clin Pediatr Endocrinol] 2022; Vol. 31 (3), pp. 199-204. Date of Electronic Publication: 2022 Jun 08.
DOI: 10.1297/cpe.2021-0069
Abstrakt: Dehydration and acidosis increase the risk for urinary stone formation. Urinary stones have been reported in three pediatric cases of diabetic ketoacidosis (DKA). A 24-h urine collection was performed for two of the three children. One patient had high urine sodium levels, while the other had low urine citrate excretion. We report the case of a 12-yr-old adolescent boy with urinary stones, new-onset type 1 diabetes mellitus (T1D), and DKA, excluding other metabolic disorders. After DKA was diagnosed, the patient received a 0.9% saline bolus and continuous insulin infusion. Hyperglycemia and ketoacidosis were well-controlled on the third day after admission. However, the patient developed abdominal pain radiating to the back. Urinary stones were suspected, and a urinalysis was performed. The patient's urine revealed significant elevation in red blood cells and calcium oxalate crystals. Computed tomography revealed a high-density left ureteric mass, suggestive of a urinary stone. Although both the previously reported pediatric cases involved metabolic diseases, additional tests in this patient excluded metabolic diseases other than T1D. DKA may be related to the formation of calcium oxalate crystals owing to dehydration and acidosis. Therefore, physicians should consider urinary stone formation in DKA patients.
Competing Interests: The authors declare no conflict of interest.
(2022©The Japanese Society for Pediatric Endocrinology.)
Databáze: MEDLINE
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