Abstract
A 14-year-old boy with Down's syndrome developed diabetic ketoacidosis, and was admitted to our hospital because of drowsiness.
He was the second child of a 32-year-old woman. He had gained weight since he was 9 years old. About 3 weeks before admission, he complained of sore throat and cough, and 2 weeks before admission, his family noticed polyuria and polydipsia. He was taken to a clinic where glycosuria was found for the first time. Two days later, his blood glucose level was 648mg/dl. He complained of loss of appetite and painful urination, and he was becomuing delirious at the day of admission to our hospital.
His blood pressure was 84/58 mmHg, pulse rate 120 per minute and regular. He weighed 80kg and his height was 164cm. He showed typical features of Down's syndrome without heart disease and chromosome analysis revealed a mosaic of 21-trisomy and 46, XY.
The urine test was (+) for protein, (++) for glucose, (++) for ketone body. Blood gas analysis revealed metabolic acidosis. The hematocrit was 38.9 percent. White blood cell count was 12, 000/mm3 with 88 percent neutrophils. The urea nitrogen was 40.9mg/dl, the blood glucose 640mg/dl.
Possible causes of the onset of his diabetes were weight gain and some infection, which overlapped with some inherent diabetic factors and obesity.
