Multiple hepatic infarctions secondary to diabetic ketoacidosis: A case report

Table 1 Laboratory data

Variable	Reference range	Admission on the emergency room	Admission on the ICU	One week after admission	Two weeks after admission	Three weeks after admission	Three months after admission
Hemoglobin (g/dL)	13-16.9	13.8	13.6	11.8	9.8	9.5	11.2
Leukocytes (leukocytes/mm3)	4000-10200	4580	4353	14350	9615	8172	5414
Platelets (platelets/mm3)	140000-400000	9380	15000	110000	262000	306000	290000
Glucose (mg/dL)	70-99	470	425
AST (U/L)	5-40	2356	805		135	149	108
ALT (U/L)	7-56	2438	1489		56	56	58
Bilirubin: total /direct (mg/dL)	0-1.2/0-0.3	1.24/0.91	2.5/2.2	10.2/8.3	12.5/10.6	10.1/8.9	3.6/1.4
Alkaline phosphatase (U/L)	40-150	168	193			376	407
Gamma-glutamyl transferase (U/L)	7-45		178			770	1665
Creatinine (mg/dL)	0.7-1.3	1.6	1.3		1.1	0.9	1.2
Arterial blood pH	7.36-7.44	7.27	7.43	7.42
Arterial blood bicarbonate (mEq/L)	22-28	15	16.7	18
Lactate (mmol/L)	0.5-2.2		4.4	2
Albumin (g/dL)	3.4-5.4		2.3	1.7			3.4
International normalized ratio	0.8-1.1		1.41	1.37			1.09
Carcinoembryonic antigen (ng/mL)	0-2.5			1
Cancer antigen 19-9 (U/mL)	0-37			4
Alpha-fetoprotein (ng/mL)	1.3-7.8			8

ICU: Intensive care unit; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase.

Table 2 Cases of hepatic infarction secondary to diabetic ketoacidosis reported in the literature

Journal	Ref.	Year	Patient	Diagnosis	Outcome
Gastroenterology	Sundaram et al[6]	1978	36-year-old male	Laparotomy and biopsy	Recovery
World Journal of Gastroenterology	Deng et al[3]	2006	53-year-old male	Hepatectomy	Recovery
Brazilian Journal of Intensive Care	Paes et al[7]	2007	67-year-old female	Necropsy	Death
Practical Diabetes International	Chen et al[8]	2007	53-year-old female	CT	Death
International Journal of Clinical and Experimental Medicine	Xu et al[12]	2017	45-year-old female	Laparoscopic biopsy	Recovery
Open Journal of Case Reports	Tiwari et al[11]	2021	37-year-old male	MRI	Recovery

CT: Computed tomography; MRI: Magnetic resonance imaging.