Concurrent Sickle Cell Anemia and Diabetes Mellitus with Ketosis in a Libyan Toddler: First National Report and Youngest Case Study
Moftah Alhagamhmad *
Pediatrics Department, Benghazi Children’s Hospital, Benghazi, Libya., Pediatrics Department, Medical School, Benghazi University, Benghazi, Libya.
Alia Alhassony
Pediatrics Department, Benghazi Children’s Hospital, Benghazi, Libya., Pediatrics Department, Medical School, Benghazi University, Benghazi, Libya.
Abdulhamid .
Pediatrics Department, Benghazi Children’s Hospital, Benghazi, Libya., Pediatrics Department, Medical School, Benghazi University, Benghazi, Libya.
Aisha Elarwah
Pediatrics Department, Benghazi Children’s Hospital, Benghazi, Libya., Pediatrics Department, Medical School, Benghazi University, Benghazi, Libya.
Shirin Alougly
Pediatrics Department, Benghazi Children’s Hospital, Benghazi, Libya., Pediatrics Department, Medical School, Benghazi University, Benghazi, Libya.
Suliman Elbrgathy
Pediatrics Department, Benghazi Children’s Hospital, Benghazi, Libya., Pediatrics Department, Medical School, Benghazi University, Benghazi, Libya.
Nuri Shembesh
Pediatrics Department, Benghazi Children’s Hospital, Benghazi, Libya., Pediatrics Department, Medical School, Benghazi University, Benghazi, Libya.
Emhemed Mousa
Pediatrics Department, Benghazi Children’s Hospital, Benghazi, Libya., Pediatrics Department, Medical School, Benghazi University, Benghazi, Libya.
*Author to whom correspondence should be addressed.
Abstract
Sickle cell Anemia (SCA) is a common inherited haemoglobinopathy resulting from a single-point mutation on the β-globin subunit of hemoglobin. It is a chronic condition with multi-system involvement. Growth delay, osteopenia and hypogonadism are common endocrine dysfunctions with a lower frequency of impaired glucose tolerance. However, there is an association between SCA and diabetes mellitus (DM), though it is very rare. Certainly, there are only a few published reports worldwide outlined this uncommon combination. In this report, we will present the first Libyan case study of co-existence of the two diseases in a-16-month-old male toddler recording the youngest patient diagnosed with such a rare combination. The child, who was diagnosed earlier with SCA, brought with concerns of frequent changing nappies (polyuria) and excessive thirst (polydipsia) for 2 weeks that worsened recently. On admission, the toddler was distressed, lethargic and his lab parameters showed hyperglycemia, ketonuria, glycosuria and acidosis, a diagnosis of diabetic ketoacidosis (DKA) on the background of SCA therefore was made. Further observations are warranted to properly guide about the diagnosis and management of such rare cases.
Keywords: Anemia, diabetes mellitus, ketosis, sickle cell, toddler