Severe Symptomatic Hypophosphatemia With Thrombocytopenia in a Child With Diabetic Ketoacidosis

Abstract

Introduction: Although asymptomatic hypophosphatemia is a common finding in diabetic ketoacidosis (DKA), severe symptomatic hypophosphatemia is an uncommon complication. Case Presentation: We report a 16-year-old female child with DKA, who developed thrombocytopenia, rhabdomyolysis, muscle weakness, and acute renal failure due to severe hypophosphatemia. She was managed with intravenous fluids, insulin infusion, phosphate therapy, and dialysis. After two weeks of hospitalization, the patient was discharged home with no squeal. Conclusions: In critically ill patients, the symptoms of hypophosphatemia may not be apparent, but clinicians should be vigilant about this complication during therapy. In cases of severe symptoms (e.g., cardiopulmonary distress, anemia and thrombocytopenia, or rhabdomyolysis), phosphate therapy under close surveillance is warranted.