{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T07:47:57Z","timestamp":1759564077568,"version":"3.40.5"},"reference-count":37,"publisher":"Walter de Gruyter GmbH","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2020-0324_abs_001_w2aab3b7c36b1b6b1aab1c15b1Aa\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To study the clinical and laboratory features, management, and outcome of pediatric non-diabetic ketoacidosis (NDKA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2020-0324_abs_002_w2aab3b7c36b1b6b1aab1c15b2Aa\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Between May 2018 and April 2020, we prospectively collected children under 18 years who presented with ketoacidosis, defined as ketosis (urinary ketones\u00a0\u2265++ and\/or serum \u03b2-hydroxybutyrate level\u00a0\u22653\u00a0mmol\/L) and metabolic acidosis (pH &lt;7.3 and HCO<jats:sub>3<\/jats:sub>\n                     <jats:sup>\u2212<\/jats:sup> &lt;15\u00a0mmol\/L). Children with HbA1c level\u00a0\u22656.5% at initial presentation and those meeting the diagnostic criteria for DM during follow-up were excluded. Data were collected on demographics, clinical and laboratory features, management, and outcome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2020-0324_abs_003_w2aab3b7c36b1b6b1aab1c15b3Aa\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Eleven children with 19 episodes of NDKA were identified. The median age was 12\u00a0months (range from 5\u00a0months to 5 years). They manifested dehydration and disturbed conscious level (all cases), convulsions (n=6), hypoglycemia (n=6), hyperglycemia (n=2) and significant hyperammonemia (n=4). Most cases required intensive care management. Death or neurodevelopmental impairment occurred in six cases. Seven cases had inborn errors of metabolism (IEMs). Other cases were attributed to starvation, sepsis, and salicylate intoxication.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2020-0324_abs_004_w2aab3b7c36b1b6b1aab1c15b4Aa\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This is the largest case series of pediatric NDKA. Ketoacidosis, even with hyperglycemia, is not always secondary to diabetes mellitus. IEMs may constitute a significant portion of pediatric NDKA. Increased awareness of this unfamiliar condition is important for prompt diagnosis, timely management, and better outcome.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2020-0324","type":"journal-article","created":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T19:47:01Z","timestamp":1602618421000},"page":"95-102","source":"Crossref","is-referenced-by-count":1,"title":["Characterization and outcome of 11 children with non-diabetic ketoacidosis"],"prefix":"10.1515","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8976-2989","authenticated-orcid":false,"given":"Elsayed","family":"Abdelkreem","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine , Sohag University , Sohag 82524, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rofaida M.","family":"Magdy","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine , Sohag University , Sohag 82524, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelrahim A.","family":"Sadek","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine , Sohag University , Sohag 82524, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2020,10,9]]},"reference":[{"key":"2023040101232121454_j_jpem-2020-0324_ref_001_w2aab3b7c36b1b6b1ab2b2b1Aa","doi-asserted-by":"crossref","unstructured":"Morton, A. 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