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The condition was complicated by profound dehydration, leukemoid reaction of neutrophilic type, and reactive thrombocytosis. Early intensive care management, mechanical ventilation, and insulin therapy led to stabilization and gradual recovery. This case highlights the critical importance of early recognition, aggressive management, and multidisciplinary care in pediatric patients with complicated DKA.<\/jats:p>","DOI":"10.1177\/11795476251375551","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T12:21:43Z","timestamp":1758025303000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Severe Diabetic Ketoacidosis With Leukemoid Reaction and Coma in a Toddler: A Case Report"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6043-7325","authenticated-orcid":false,"given":"Ievgeniia","family":"Burlaka","sequence":"first","affiliation":[{"name":"Department of Pediatrics \u21164, Bogomolets National Medical University, Kyiv, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serhii","family":"Babii","sequence":"additional","affiliation":[{"name":"Department of Pediatrics \u21164, Bogomolets National Medical University, Kyiv, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ihor","family":"Kovalchuk","sequence":"additional","affiliation":[{"name":"Department of Pediatrics \u21164, Bogomolets National Medical University, Kyiv, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc21-0770"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/children12010110"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.9017"},{"issue":"12","key":"e_1_3_3_5_2","article-title":"Leukemoid reaction with severe diabetic ketoacidosis","volume":"15","author":"Hussein TW","year":"2023","unstructured":"Hussein TW, Almualem ZD, Almualem FD, Zainaldeen BA, Alshaikh ZJ. 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