Horner’s syndrome in a 16-year-old patient during diabetic ketoacidosis
- Department of Endocrinology and Diabetology, The Children’s Memorial Health Institute, Warsaw, Poland
Introduction
Diabetic ketoacidosis (DKA) at the onset of newly diagnosed type 1 diabetes (T1D) is associated with neurological complications. Horner syndrome (HS), consisting of miosis, ptosis, and anhidrosis, has not previously been reported during DKA in children.
Case report
The case concerns a 16-year-old patient with newly diagnosed T1D with DKA (pH 6.86, sBE –26.1 mmol/l, HCO3 5.6 mmol/l, glucose 513 mg/dl). Treatment included intravenous insulin therapy and fluid replacement. On the fourth day of hospitalization, pupillary asymmetry and ptosis of the upper left eyelid were observed. Mannitol treatment was introduced; brain computed tomography revealed no abnormalities. After neurological and ophthalmological assessment, a diagnosis of HS as a complication of DKA was made. During a follow-up, 6 months after diagnosis, features of HS continued to be observed, but after 12 months, symptoms gradually resolved.
Conclusions
Neurological evaluations continue to be essential after clinical improvement in DKA; although infrequent, neurological complications can occur.
Keywords
Horner’s syndrome, diabetic ketoacidosis, diabetes type 1
Integrated with
