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Endocrinology Peadiactrics An 11 year old girl presents unconscious to her local hospital

An 11 year old girl presents unconscious to her local hospital

image

 

She has been unwell for 2 days complaining of heavy, aching legs.

On arrival, she has a respiratory arrest and is immediately intubated and ventilated.

She had been admitted 2 years previously with a low blood sugar, hyponatraemia and vomiting and improved with fluid.

(Since the episode 2 years ago, she had become increasingly less active and saw the GP 4 weeks. A blood test showed a sodium of 125 mmol/l.)

On admission PICU she was found to have evidence of rhabdomyolysis (elevated creatinine kinase with myoglobinuria)

 

New Blood results

Na 113

K 7.9

Glucose< 1 mmol/l

 

 

What is the diagnosis?

What clinical sign would you look for?

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