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      Hypothalamopituitary Deficiency and Precocious Puberty following Hyperhydration in Diabetic Ketoacidosis

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          Abstract

          We report on a 5-year-old child who survived an intracerebral crisis, following ketoacidosis-revealing diabetes (DKA), with visual impairment due to a vascular occipital lesion. Two and 4 months after the initial episode, a unique hypothalamopituitary disorder consisting in GH, ACTH, TSH deficiencies and central precocious puberty, was detected. Cranial magnetic resonance images showed no visible lesion in the hypothalamopituitary region. The most likely hypothesis is the ischemia of hypothalamopituitary and occipital regions following possible cerebral edema after hyperhydration. She survived with low visual acuteness and received a combined replacement therapy for the neuroendocrinological deficiencies. This case emphasizes that the rehydration at the initial period of DKA is critical, especially when risk factors for cerebral edema are present (young age, marked hyponatremia). The neuroendocrinological consequences of acute cerebral edema are rare, but physicians must be attentive in survivors of these accidents.

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          Author and article information

          Journal
          HRE
          Horm Res Paediatr
          10.1159/issn.1663-2818
          Hormone Research in Paediatrics
          S. Karger AG
          1663-2818
          1663-2826
          1992
          1992
          03 December 2008
          : 37
          : 1-2
          : 60-63
          Affiliations
          Service d’Endocrinologie et de Diabétologie Pédiatriques, Hôpital Robert-Debré, Paris, France
          Article
          182283 Horm Res 1992;37:60–63
          10.1159/000182283
          1328005
          © 1992 S. Karger AG, Basel

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          Page count
          Pages: 4
          Categories
          Case Report

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