PEDIATRICS Vol. 43 No. 4 April 1969, pp. 620-622
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Diabetic Ketoacidosis with Fatal Cerebral Edema

Philip Warren M.D.1, Erlinda S. Villaluz M.D.1, and Harold Rosenberg M.D.1

1 Department of Pediatrics St. Mary's Hospital Waterbury, Connecticut

One case of diabetic ketoacidosis with irreversible cerebral edema in a 10-year-old boy is presented. Death ensued in spite of apparently adequate fluid, electrolyte, and insulin therapy, and it followed a brief period of clinical and chemical improvement suddenly and unexpectedly. Although the pediatric literature makes no note of this syndrome, a review of the general medical literature does reveal some scattered case reports which deal with a similar pattern.

The pathogenesis is discussed with several mechanisms presented as possible factors. Suggestions are made regarding modification of therapy, but these are admittedly tentative and require further studies.