Table 1 The clinical report, treatment process, and laboratory findings after the first 24 hours of birth
From: Iranian neonatal diabetes mellitus due to mutation in PDX1 gene: a case report
Neonate’s age | Clinical report | Treatment progress | Laboratory findings | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
HB (g/dL) | WBC (n/ml) | CRP (mg/l) | BS (mg/dl) | Bili-T (mg/dl) | Bili-D (mg/dl) | Amylase | AST (U/L) | ALT (U/L) | |||
One-day-old to 7-day-old | -Severe IUGR -Embryonic ultrasound document = duodenal atresia detection -HR = 130 -RR = 40 -spO2 = 95% -Echocardiography = ASD | -Admission in NICU -Oxygen therapy by oxygen hood -Broad-spectrum antibiotic therapy (ciprofloxacin, colistin, linezolid, amphotericin B) -Injection of pack cell, IVIG, fresh frozen plasma, cryoprecipitate, and G-CSF -Surgery of duodenal atresia | 6.4 | 2.9 | – | – | – | – | – | – | – |
7-day-old to 20-day-old | -BP = 75/43(mmHg) -Ultrasound of kidneys = normal Ultrasound of liver = normal Ultrasound of brain = GMH -Electroencephalography = Abnormal | -Phenobarbital; 3 mg/kg | 10.5 | 4.49 | – | – | – | – | – | – | – |
20-day-old to 25-day-old | -Lumbar puncture culture = negative -Glucose test every 2 hours = hyperglycemia | Subcutaneous insulin injection/0.03 unit | – | – | – | -First three levels every 2 hours were: 280, 300, 496 -After subcutaneous regular insulin injection: 360 | – | – | – | – | – |
26-day-old | -spO2 = 98% -BP = 92/48 -Glucose test every 2 hours = hyperglycemia -MRI = hypogenesis of the corpus callosum | Subcutaneous regular insulin injection; 0.03unit | 8.7 | – | – | 157 | – | – | – | – | – |
26-day-old to 31-day-old | -Glucose test every 2 hours -Stool exam = acholic Stool -Rubella IgG: high -CMV IgG: high -PCR CMV = negative | -Subcutaneous regular insulin injection; 0.03 - | 9.3 | 5.4 | 68.0 | 206 | – | – | – | – | – |
32-day-old | -BP = 87/72 -Glucose test every four hours -Diarrhea Resistance to insulin Pancreas ultrasound = normal | -Intravenous insulin injection; if patient is NPO (start the dose of 0.02 unit) | – | – | – | 200 | 4.4 | 3.9 | 2.9 | 57 | 42 |
32-day-old to 40-day-old | -Genetic counseling -Pedigree determination -Genotyping | -Probability of neonate diabetes | – | – | – | – | – | – | – | – | – |
40-day-old to 48-day-old | Glucose test every 4 hours Stool exam = acholic Stool -Fisting in fingers -Severe FTT -Doppler ultrasound = fatty liver -Eye examination = normal | - Intravenous insulin injection (0.1 u/Kg/hour; if BS > 250) Glibenclamide prescription -Ursobil (ursodeoxycholic acid) prescription | 4.6 | 34.0 | – | – | – | – | – | – | – |
48-day-old to 53-day-old | -Glucose test every 4 hours | -If BS > 250 prescription insulin, if BS < 50 prescription dextrose 10% | – | – | – | – | – | – | – | – | – |
57-day-old | -Glucose test every 4 hours | -Regular insulin;0.2 and NPH insulin; 0.4 after 48 hours | -After regular insulin; 0.2: 564 After NPH insulin; 0.4: 228 | ||||||||
60-day-old | Glucose test every 4 hours | -If BS > 250 prescription insulin, if BS < 50 prescription dextrose 10% | 166 | ||||||||
65-day-old | Discharged at 65-days old against medical advice | ||||||||||