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Ann Pediatr Endocrinol Metab > Volume 17(4); 2012 > Article
DOI: https://doi.org/10.6065/apem.2012.17.4.253   
Diabetic Ketoacidosis and Cerebral Infarction Leading to a Diagnosis of Moyamoya Disease.
Hwa Young Kim, Hae Woon Jung, Young Ah Lee, Choong Ho Shin, Kyu Chang Wang, Sei Won Yang, Kang Ho Cho
1Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea. chshinpd@snu.ac.kr
2Department of Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
3Department of Pediatrics, Gil Hospital, Gachon University of Medicine and Science, Incheon, Korea.
Abstract
There have been few reports of concomitant moyamoya disease (MMD) with type 1 diabetes mellitus. We report a case of MMD associated with type 1 diabetes mellitus in a 9-year-old boy who presented with altered mentality and left side motor weakness. Laboratory test results indicated diabetic ketoacidosis (DKA), but his stuporous mental state and hemiparesis persisted despite DKA management. Brain magnetic resonance imaging revealed multiple cerebral infarcts and stenosis of cerebral arteries with basal collateral vessels, suggesting MMD. After management of DKA and successive surgery for MMD, his hemiparesis improved without further ischemic attacks. Although rare, the possibility of comcomitant MMD should be considered in a type 1 diabetes mellitus patient with neurologic symptoms and cerebral infarction.
Keywords: Brain ischemia;Child;Diabetic ketoacidosis;Diabetes mellitus, type 1;Moyamoya disease
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