{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T16:12:13Z","timestamp":1680365533139},"reference-count":8,"publisher":"Walter de Gruyter GmbH","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,26]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n Diabetic ketoacidosis is a common emergency in type 1 diabetes mellitus patients. But rarely, they may present with alkalemia instead of acidosis. Diabetic ketoalkalosis which has been reported in adults can also be present in children with type 1 DM. The usual factors causing alkalemia were not found in our patients. This entity may manifest in both newly diagnosed and treated patients.<\/jats:p>\n <\/jats:sec>\n \n Case presentation<\/jats:title>\n The first patient, an 8\u00a0year male presented with features of DKA, was diagnosed for the first time as type 1 DM, but was found to have alkalemia. The second patient, a 7\u00a0year female was a known case of Type 1 DM on insulin, who presented with dehydration and alkalemia. Both were treated with hydration and insulin and made complete recovery.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A normal or alkalotic pH does not essentially eliminate DKA and needs to be evaluated further to identify the underlying acid\u2013base disturbance.<\/jats:p>\n <\/jats:sec>","DOI":"10.1515\/jpem-2022-0115","type":"journal-article","created":{"date-parts":[[2022,7,13]],"date-time":"2022-07-13T20:58:15Z","timestamp":1657745895000},"page":"1316-1318","source":"Crossref","is-referenced-by-count":0,"title":["Diabetic ketoacidosis masquerading behind alkalemia an undiagnosed or missed variant of diabetic ketoacidosis"],"prefix":"10.1515","volume":"35","author":[{"given":"Vishnu Priyaa","family":"Rajasegaran","sequence":"first","affiliation":[{"name":"Department of Pediatrics , Sri Manakula Vinayagar Medical College and Hospital , Puducherry , India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Preethi","family":"Tamilarasan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , Sri Manakula Vinayagar Medical College and Hospital , Puducherry , India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thambiprabagarane","family":"Kalaimani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , Sri Manakula Vinayagar Medical College and Hospital , Puducherry , India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2022,7,13]]},"reference":[{"key":"2023040100332855084_j_jpem-2022-0115_ref_001","doi-asserted-by":"crossref","unstructured":"Watanabe, Y, Noda, K, Akazawa, K, Fukuyama, J. Two cases of type 1 diabetic women with diabetic ketoacidosis presenting as alkalaemia. Diabetes Res Clin Pract 2009;83:e54\u20137. https:\/\/doi.org\/10.1016\/j.diabres.2008.11.020.","DOI":"10.1016\/j.diabres.2008.11.020"},{"key":"2023040100332855084_j_jpem-2022-0115_ref_002","doi-asserted-by":"crossref","unstructured":"Nanavati, S, Kumar, V, Melki, G, Singhal, M. Diabetic ketoalkalosis: misnomer or undiagnosed variant of diabetic ketoacidosis. BMJ Case Rep 2018;2018:bcr2018226092.","DOI":"10.1136\/bcr-2018-226092"},{"key":"2023040100332855084_j_jpem-2022-0115_ref_003","doi-asserted-by":"crossref","unstructured":"Rastegar, A. Use of the DeltaAG\/DeltaHCO3- ratio in the diagnosis of mixed acid-base disorders. J Am Soc Nephrol 2007;18:2429\u201331. https:\/\/doi.org\/10.1681\/asn.2006121408.","DOI":"10.1681\/ASN.2006121408"},{"key":"2023040100332855084_j_jpem-2022-0115_ref_004","unstructured":"Oosthuizen, NM. Approach to acid-base disorders\u00a0\u2013 a clinical chemistry perspective. Cont Med Educ 2012;30:230\u20134."},{"key":"2023040100332855084_j_jpem-2022-0115_ref_005","doi-asserted-by":"crossref","unstructured":"Svart, MV, Voss, TS, Bayat, M, Madsen, LR, Andersen, LT, Poulsen, PL, et al.. Rare presentations of ketoacidosis: diabetic ketoalkalosis and ketoacidosis secondary to fasting and muscular dystrophy. Clin Diabetes 2015;33:37\u20139. https:\/\/doi.org\/10.2337\/diaclin.33.1.37.","DOI":"10.2337\/diaclin.33.1.37"},{"key":"2023040100332855084_j_jpem-2022-0115_ref_006","doi-asserted-by":"crossref","unstructured":"Heddy, N. Guideline for the management of children and young people under the age of 18 years with diabetic ketoacidosis (British Society for Paediatric Endocrinology and Diabetes). Arch Dis Child Educ Pract Ed 2021;106:220\u20132. https:\/\/doi.org\/10.1136\/archdischild-2020-320076.","DOI":"10.1136\/archdischild-2020-320076"},{"key":"2023040100332855084_j_jpem-2022-0115_ref_007","doi-asserted-by":"crossref","unstructured":"Kraut, JA, Madias, NE. Serum anion gap: its uses and limitations in clinical medicine. Clin J Am Soc Nephrol 2007;2:162\u201374. https:\/\/doi.org\/10.2215\/cjn.03020906.","DOI":"10.2215\/CJN.03020906"},{"key":"2023040100332855084_j_jpem-2022-0115_ref_008","doi-asserted-by":"crossref","unstructured":"Huggins, EA, Chillag, SA, Rizvi, AA, Moran, RR, Durkin, MW. Diabetic ketoalkalosis in children and adults. South Med J 2014;107:6\u201310. https:\/\/doi.org\/10.1097\/smj.0000000000000040.","DOI":"10.1097\/SMJ.0000000000000040"}],"container-title":["Journal of Pediatric Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2022-0115\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2022-0115\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T15:45:11Z","timestamp":1680363911000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2022-0115\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,13]]},"references-count":8,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,8,9]]},"published-print":{"date-parts":[[2022,10,26]]}},"alternative-id":["10.1515\/jpem-2022-0115"],"URL":"https:\/\/doi.org\/10.1515\/jpem-2022-0115","relation":{},"ISSN":["0334-018X","2191-0251"],"issn-type":[{"value":"0334-018X","type":"print"},{"value":"2191-0251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,13]]}}}