scholarly journals New-Onset Diabetes in Children during COVID-19: Clinical Case Report

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
M. Aabdi ◽  
A. Aarab ◽  
O. Es-Saad ◽  
K. Malki ◽  
H. Bkiyar ◽  
...  

Introduction. Data of COVID-19 in newborns and children are limited, and clinical manifestations are nonspecific and might delay the diagnosis, which might lead to severe complications. In this clinical case, we will describe new-onset diabetes with consciousness impairment as an atypical revealing way of COVID-19. Case. A 3-year-old child presented to the Emergency Department with loss of consciousness (without fever), lethargy, and stupor. Clinical assessment on admission found an unconscious child with a pediatric Glasgow Coma Scale of 10/15 with no localizing signs or meningeal syndrome, polypneic of 35 breaths/min, pulse oximetry of 90%, with signs of overall dehydration: skin folds, sunken eyes, tachycardia of 160 beats/minute, and recoloring time superior at 3 seconds. Laboratory findings showed hyperleukocytosis of 16000/mm3, lymphopenia of 450/mm3, glycemia of 5 g/L with a correct ionogram : corrected natremia of 139 mmol/L, serum potassium of 4.5 mmol/L, glycosuria of 3+, ketonuria of 2+, and HbA1c of 10%, and COVID-19 RT-PCR came back positive. Conclusion. COVID-19 might be revealed with atypical symptoms including new-onset diabetes and diabetic ketoacidosis; therefore, clinicians must suspect it in children with blood glucose and HbA1c at the time of admission. This will help to manage patients with hyperglycemia early.

2018 ◽  
Vol 5 (1) ◽  
pp. 151
Author(s):  
Raman Sharma ◽  
Sunil Mahavar ◽  
Mayank Gupta ◽  
Sandeep Kumar ◽  
Jai Purohit ◽  
...  

Background: To describe the diversity of clinical manifestations, laboratory findings and outcome of chikungunya fever in patients attending SMS Hospital, Jaipur during the epidemic of 2016 (September to November).Methods: All cases of febrile illness with polyarthralgia/polyarthritis diagnosed as chikungunya were analyzed. Diagnosis was made by ELISA based IgM serology and RT PCR assay.Results: A total of 200 cases were studied. All of them presented with fever, severe crippling joint pain & tenderness, headache, anorexia and body rash. On examination, there was periarticular edema, erythema, and tenderness in joints with post auricular and cervical lymphadenopathy. Unusual manifestations were hyper pigmentation of face and forehead and scrotal ulcers. On investigations patient had leucopenia with elevated level of SGOT, SGPT with normal bilirubin levels. Other complications observed were encephalopathy, encephalitis, myocarditis and hepatitis. There was no mortality in this group.Conclusions: Chikungunya though prevalent is under-reported. The diagnostic certainty is mandated by presence of febrile transiently crippling polyarthragias / arthritis. On analyzing a large series, unusual clinical features may emerge.


2021 ◽  
Author(s):  
Andrea Laurenzi ◽  
Amelia Caretto ◽  
Chiara Molinari ◽  
Elena Bazzigaluppi ◽  
Cristina Brigatti ◽  
...  

AbstractObjectiveThe aim of the current study was to compare clinical characteristics, laboratory findings and major outcomes of patients hospitalized for COVID 19 pneumonia with new-onset or preexisting diabetes.DesignA cohort of 176 adult patients with a diagnosis of pre-existing (n=112) or new-onset diabetes (n=55) and confirmed COVID-19 pneumonia was studied. Clinical outcomes and laboratory findings were analysed according to the presence of preexisting or new-onset diabetes. The time to viral clearance and the persistence of hyperglycemia were assessed during the follow-up after hospital discharge.ResultsPatients with new-onset diabetes had lower BMI, significantly less comorbidities and higher levels of inflammatory markers and indicators of multi-organ injury than those with preexisting diabetes. No differences between preexisting and new onset diabetes were evident for symptoms at admission, humoral response against SARS-CoV-2 or autoantibodies to glutamic acid decarboxylase or interferon alpha-4. New-onset diabetes was independently associated with the risk of adverse clinical outcome defined as ICU admission or death (HR 2.11, 95% CI 1.34-3.31; p=0.001), even after adjustment for age, sex and other selected variables associated with COVID-19 severity. Furthermore, we documented a negative association (HR 0.661, 95% CI 0.43-1.02; p=0.063) between new-onset diabetes and the time to swab negativization. During follow-up we observed that in 30% of the patients with new-onset diabetes hyperglycemia reversed when the viral infection resolved.ConclusionsThe recognition of new-onset diabetes as a specific clinical entity associated with COVID-19 pneumonia is relevant for early and appropriate patient management and close monitoring for the progression of disease severity.


2021 ◽  
Author(s):  
Muhammad Ilham Aldika Akbar ◽  
Khanizyah Erza Gumilar ◽  
Rino Andriya ◽  
Manggala Pasca Wardhana ◽  
Pungky Mulawardhana ◽  
...  

Objectives:. The data on clinical manifestations and pregnancy outcomes of pregnant women with COVID-19 are limited, particularly in developing countries. The aim of this study is to analyze the clinical manifestations and pregnancy outcomes in COVID-19 maternal cases in a large referral hospital in Indonesia Methods: The study used a prospective cohort design of all pregnant women with suspected COVID-19. Subjects were divided into COVID-19 and non COVID-19 group based on real-time polymerase chain reaction (RT-PCR) of SARS-CoV-2. The clinical characteristics, laboratory results, and pregnancy outcomes were then compared between both groups. Results: From 141 suspected maternal cases, 62 COVID-19 cases were confirmed (43.9%), while 79 suspected cases were found to be negative (56.1%). The clinical manifestations and laboratory findings between the two groups were not significantly different (p>0.05). However, the maternal mortality directly caused by COVID-19 was significantly higher compared to the non-COVID-19 group (8.3 vs 1.3%; p=0.044; OR 6.91, 95% CI: 0.79-60.81). Conclusions: The clinical manifestation and laboratory of suspected pregnant women with positive and negative RT-PCR COVID-19 result are similiar. However, within the Indonesian setting, COVID-19 strongly increases the risk of maternal death through both direct and indirect factors.


Author(s):  
Benjamin G Challis ◽  
Chung Thong Lim ◽  
Alison Cluroe ◽  
Ewen Cameron ◽  
Stephen O’Rahilly

Summary McKittrick–Wheelock syndrome (MWS) is a rare consequence of severe dehydration and electrolyte depletion due to mucinous diarrhoea secondary to a rectosigmoid villous adenoma. Reported cases of MWS commonly describe hypersecretion of mucinous diarrhoea in association with dehydration, hypokalaemia, hyponatraemia, hypochloraemia and pre-renal azotemia. Hyperglycaemia and diabetes are rarely reported manifestations of MWS. Herein we describe the case of a 59-year-old woman who presented with new-onset diabetes and severe electrolyte derangement due to a giant rectal villous adenoma. Subsequent endoscopic resection of the tumour cured her diabetes and normalised electrolytes. This case describes a rare cause of ‘curable diabetes’ and indicates hyperaldosteronism and/or whole-body potassium stores as important regulators of insulin secretion and glucose homeostasis. Learning points McKittrick–Wheelock syndrome (MWS) is typically characterised by the triad of pre-renal failure, electrolyte derangement and chronic diarrhoea resulting from a secretory colonic neoplasm. Hyperglycaemia and new-onset diabetes are rare clinical manifestations of MWS. Hyperaldosteronism and/or hypokalaemia may worsen glucose tolerance in MWS. Aggressive replacement of fluid and electrolytes is the mainstay of acute management, with definitive treatment and complete reversal of the metabolic abnormalities being achieved by endoscopic or surgical resection of the neoplasm.


2010 ◽  
Vol 17 (6) ◽  
pp. E10-E12 ◽  
Author(s):  
Sinan Akbayram ◽  
Murat Dogan ◽  
Cihangir Akgun ◽  
Erdal Peker ◽  
Mehmet Parlak ◽  
...  

Brucellosis is a multisystem disease with a broad spectrum of clinical manifestations; hematological abnormalities ranging from fulminant as of disseminated intravascular coagulation (DIC) to anaemia, leucopoenia, thrombocytopenia, and clotting disorders. In this report, we present DIC in a case of brucellosis because of rare presentation. A 3-year-old boy was admitted with the complaints of continuous fever, vomiting, abdominal pain, and bruise on leg. He looked pale and his physical examination revealed purpuric skin lesions on both legs. A mild hepatosplenomegaly was noted on palpation. Laboratory tests showed hematocrit 21%, hemoglobin 7 g/dL, platelet count 20,000/mm3, prothrombin time 19 seconds, activated partial thromboplastin time 48 seconds, plasma fibrinogen level 20 mg/dL, andd-dimer 8 µg/mL. Serum antibrucella titration agglutination test was found to be 1 of 1280 positive. Blood cultures performed on specimens obtained at the time of admission yielded Brucella melitensis. The clinical and laboratory findings were consistent with DIC.


Author(s):  
Jin-Wei Ai ◽  
Jun-Wen Chen ◽  
Yong Wang ◽  
Xiao-Yun Liu ◽  
Wu-Feng Fan ◽  
...  

SummaryObjectiveTo describe the epidemiological and clinical characteristics of the Coronavirus Disease 2019 (COVID-19) hospitalized patients and to offer suggestions to the urgent needs of COVID-19 prevention, diagnosis and treatment.MethodsWe included 102 confirmed COVID-19 cases hospitalized in Xiangyang No.1 people’s hospital, Hubei, China until Feb 9th, 2020. Demographic data, laboratory findings and chest computed tomographic (CT) images were obtained and analyzed.FindingsAll cases were confirmed by real-time RT-PCR, including 52 males and 50 females with a mean age of 50.38 years (SD 16.86). Incubation time ranged from one to twenty days with a mean period of 8.09 days (SD 4.99). Fever (86[84.3%] of 102 patients), cough (58[57%]), fatigue (28[27%]), shortness of breath (24[23%]), diarrhea (15[15%]), expectoration (13[12%]), inappetence (11[10%]) were common clinical manifestations. We observed a decreased blood leukocyte count and lymphopenia in 21 (20.6%) and 56 (54.9%) patients, respectively. There were 66 (68%) of 97 patients with elevated C-reactive protein levels and 49 (57.6%) of 85 with increased erythrocytes sedimentation rate. Higher levels of procalcitonin and ferritin were observed in 19 (25.3%) of 75 and 12 (92.3%) of 13 patients, respectively. Eight patients were admitted to intensive care unit (ICU), six developed respiratory failure, three had multiple organ failure and three died. The cumulative positivity rate over three rounds of real-time RT-PCR was 96%. One-hundred patients were found with typical radiological abnormalities in two rounds of chest CT scans, indicating a 98% consistency with real-time RT-PCR results.InterpretationMost COVID-19 patients in Xiangyang were secondary cases without sex difference, and the rate of severe case and death was low. Middle-to-old-age individuals were more susceptible to the virus infection and the subsequent development of severe/fatal consequences. The average incubation period was longer among our patients. We recommend prolonging the quarantine period to three weeks. Three times real-time RT-PCR plus two times CT scans is a practical clinical diagnosis strategy at present and should be used to increase the accuracy of diagnosis, thereby controlling the source of infection more effectively.


2016 ◽  
Vol 14 (2) ◽  
pp. 89-91
Author(s):  
Lutfiye Bilge Caliskan ◽  
Tugba Karadeniz ◽  
Sumeyye Ekmekci ◽  
Banu Yilmaz Avcioglu ◽  
Mehmet Tanrisev ◽  
...  

Abstract Multiple myeloma is a malignant disease that results in the proliferation of a single plasma cell clone. The clinical manifestations are anemia, bone pain, bone fractures, hypercalcemia, hypergammaglobulinemia, increased erythrocyte sedimentation rate, rouleaux formation on the peripheral blood smear and rarely increased serum viscosity. Rarely cast nephropathy associated with acute renal failure may be the first finding of multiple myeloma. We report a clinical case of a 44-year-old female patient who presented with acute renal failure due to cast nephropathy without myeloma’s typical clinical and laboratory findings. In the clinical case presented here, we highlight that multiple myeloma can be presented with acute renal failure and without any other typical symptoms.


2021 ◽  
Vol 4 (2) ◽  
pp. 01-09
Author(s):  
Murat Muratoglu ◽  
Sevil Ozek ◽  
Hayrettin Meftun Kaptan ◽  
Ishaaq S akwa Eshikumo ◽  
Ishaaq Sakwa Eshikumo

Introduction: This study aimed to define the clinical features and laboratory findings that may be associated with COVID-19 pneumonia in patients with suspected COVID-19 pneumonia who presented to the emergency department in order to be able to recognize the disease early until molecular tests are available, and thus to isolate sick people as soon as possible. Patients and Methods: We retrospectively examined patients who were evaluated with the suspicion of COVID-19 between March 2020 and August 2020. We used the patient information management system to record patient demographic and clinical features, laboratory findings, and CT results. In subgroups with and without pneumonia, we compared these characteristics in confirmed COVID-19 patients. Results: Our study included 1,277 patients who were evaluated for suspected COVID-19. COVID-19 pneumonia was detected in 71.2% (n=210) of a total of 295 (23.4%) patients with a diagnosis of COVID-19 who were confirmed by RT-PCR positivity. Although 56.2% (n=18) of those with pneumonia were men, no statistically significant relationship was detected between gender distribution and CT findings (p=0.449). When we compared the patients in 3 subgroups according to age groups, it was observed that 59.4% (n=38) of those with negative CT findings were in the 18-44 age group, and 44.8% (n=94) of those with positive CT findings were 65 and over age group, and this distribution was found to be statistically significant (p<0.001). Pneumonia was detected in 58.3% (n=49) of COVID-19 cases (n=84) with a suspected exposure history (p=0.008). The most common symptoms in patients with positive CT findings (n=210) were fever (40.5% n=85) and fatigue (40.5% n=85), cough (32.9% n=69), and shortness of breath (28.6% n=60). The most common comorbidity in cases diagnosed with COVID-19 was HT (33.9%; n=100/295), followed by AF (19.3%; n=57/295), and the rates of HT and AF in those with COVID-19 pneumonia were statistically significantly higher compared to the CT-negative group (p<0.001 and p=0.002, respectively).COVID-19 pneumonia was more common in hospitalized patients (n=124), and hospitalization lengths were longer in both emergency and ICU admissions (p<0.001 and p=0.008). In our analysis in terms of the survival relationship, it was observed that 87.5% (n=35) of the COVID-19 cases who died had pneumonia (p<0.042). Low saturation and high respiratory rate per minute at the time of admission were associated with COVID-19 pneumonia (p<0.001). In the group with COVID-19 pneumonia, haemoglobin, GFR, and pCO2 values were recorded lower at the time of admission compared to patients with negative CT (p<0.001, p<0.001, p<0.05, respectively), while leukocytes, neutrophils, CRP, D-dimer, LDH, hs-troponin, AST and bilirubin were recorded as higher (p<0.05, p<0.01, p<0.001, p<0.001, p<0.001, p<0.001, p=0.01, p=0.01, respectively). Conclusion: Identifying patient features linked with COVID-19 pneumonia at the time of admission may influence our decision to have CT scans in emergency departments, regardless of the RT-PCR result, and may result in early disease identification and treatment.


2021 ◽  
Vol 6 (6) ◽  
pp. 152-157
Author(s):  
I. O. Filiuk ◽  
◽  
O. I. Kalbus ◽  
N. P. Shastun ◽  
D. I. Andreichenko ◽  
...  

COVID-19 is an urgent problem all over the world that affects not only the respiratory system, but also causes many neurological disorders. In connection with the clinical manifestations of COVID-19, further detailed study of neurological complications is required, such as ischemic and hemorrhagic strokes, damage to the peripheral nervous system, and inflammatory diseases of the brain. Some neurological symptoms after an illness may persist for several weeks or even months. Hemorrhagic encephalitis is one such complication of COVID-19. Taking into account the growth of COVID-19 and frequent neurological complications after a previous illness, more and more often patients will seek medical help from a specialist, such as a neurologist, psychologist, psychiatrist. The only protection against COVID-19, which causes serious complications, is vaccination. The purpose of the study was to highlight a rare case of hemorrhagic encephalitis, which developed against the background of the previous COVID-19 disease. Materials and methods. The work is based on a description of a clinical case of hemorrhagic encephalitis in a patient who has undergone COVID-19. The modern literature data on the clinical and diagnostic features and therapeutic possibilities of hemorrhagic encephalitis are presented. Results and discussion. The article examines data on the clinical manifestations of COVID-19, which can occur in both mild and severe forms, reflects the diagnostic criteria of this disease, highlights treatment approaches, discusses in detail and provides data on the main aspects of the pathogenetic mechanisms underlying development of the disease. Complications of COVID-19 have been described, not only from the central and peripheral nervous system, but also from other systems. The second part of the article is presented in the form of a clinical case of hemorrhagic encephalitis against the background of the undergone COVID-19, which was recorded in our hospital. This part of the article describes in detail the patient's complaints and anamnestic data, the data of the somatic and neurological examination at the time of admission to the hospital and in dynamics, and describes the treatment tactics. Attention is especially focused on the cognitive functions of this patient, which will become the reason for seeing a psychiatrist in the future. Conclusion. Neurological complications of COVID-19 are increasingly registered, requiring close attention from neurologists. Hemorrhagic encephalitis can be one of these complications


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