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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           
  1. ALT alanine aminotransferase, ASD atrial septal defect, AST aspartate aminotransferase, Bili-D bilirubin direct, Bili-T total bilirubin, BP blood pressure, BS blood sugar, CMV cytomegalovirus, CRP C-reactive protein, FTT FailureTo Thrive, G-CSF granulocyte colony-stimulating factor, GMH germinal matrix hemorrhage, HGB hemoglobin, HR heart rate, IUGR intrauterine growth retardation, IVIG intravenous immunoglobulin, MRI magnetic resonance imaging, NICU neonatal intensive care unit, NPH isophane insulin, NPO Nothing by Mouth, PCR polymerase chain reaction, RR respiratory rate, spO2 Saturation of Peripheral Oxygen, WBC white blood cell