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Rhabdomyolysis Without Detectable Myoglobulinuria Due to Severe Hypophosphatemia in Diabetic Ketoacidosis

Kutlu, Alev Oguz MD; Kara, Cengiz MD; Cetinkaya, Semra MD

Pediatric Emergency Care:
doi: 10.1097/PEC.0b013e31821dc68a
Illustrative Cases
Abstract

Clinical signs of hypophosphatemia, even when severe, are rare in diabetic ketoacidosis despite their high frequency in this condition. This article presents a patient with rhabdomyolysis due to severe hypophosphatemia, where the level of serum phosphorus was observed to be as low as 0.42 mg/dL on the 16th hour of ketoacidosis treatment. The patient developed acute tubular necrosis due to rhabdomyolysis, but there was no blood reaction in the urine, and the creatine kinase increased to 1200 U/L. The patient was treated without dialysis and was cured after a polyuria period of 2 months after the oliguric period.

Author Information

From the Dr Sami Ulus Children's Hospital, Pediatric Endocrinology Clinic, Ankara, Turkey.

Reprints: Alev Oğuz Kutlu, MD, Nenehatun caddesi No. 61/3, 06430 Ankara, Turkey (e-mail: alevkutlu64@yahoo.com.tr).

© 2011 Lippincott Williams & Wilkins, Inc.