Case Report
Combined Hyperglycemic Hyperosmolar Syndrome and Diabetic Ketoacidosis Associated with COVID-19 in a Pediatric Patient
Table 1
Initial laboratory values and peaked values for the inflammatory markers.
| | Variable | Initial values | Reference ranges |
| | HbA1c (%) | 13 | 4–6 | | pH | 6.9 | 7.36–7.44 | | Bicarbonate (mEq/L) | 6 | 21–31 | | Glucose (mg/dL) | 1858 | 70–110 | | Beta-hydroxybutyrate (mg/dL) | 46 | 0.2–2.8 | | Anion gap (mEq/L) | 22 | 3–10 | | Effective osmolarity (mOsm/kg) | 345 | 283–299 | | WBC (K/mm3) | 9.7 | 4.5–11 | | Hemoglobin (g/dL) | 15.7 | 12–16 | | Platelets (K/mm3) | 202 | 140–440 | | Sodium (mEq/L) | 121 | 135–145 | | Potassium (mEq/L) | 6.1 | 3.5–5 | | Chloride (mEq/L) | 93 | 98-107 | | Phosphorous (mg/dL) | <1 | 2.5–5 | | BUN (mg/dL) | 47 | 7–23 | | Creatinine (mg/dL) | 4.5 | 0.6–1.3 | | Amylase (U/L) | 120 | 40–140 | | Lipase (U/L) | 666 | 0–160 | | Troponin (ng/L) | 343 (peak: 481) | 3–17 | | CRP (mg/L) | 210 (peak: 362) | <10 | | Ferritin (ng/mL) | 172 (peak: 1546) | 12–300 | | LDH (U/L) | 120 (peak: 2295) | 140–271 | | D-dimer (μg/mL) | 4.15 (peak: 12.26) | <0.5 | | Fibrinogen (mg/dL) | 175 (peak: 516) | 183–503 | | CPK (U/L) | 210 (peak: 10375) | 20-200 |
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