• Houn Joe Shim, Byung Min Yoo, Seon Mi Jin, and Min Jae Kang.
• Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
• Medicine (Baltimore). 2021 Apr 30; 100 (17): e25702e25702.

RationaleDiabetic ketoacidosis (DKA) can cause several complications. Among them, cardiac complications are the most fatal and difficult to detect. Cardiac markers are prognostic factors for morbidity and mortality in adult patients with DKA. But, there have been very few discussed cases in pediatrics. We report a case of severe DKA in child with elevated cardiac enzymes and prolonged QT interval.Patient ConcernsA 12-year-old girl admitted by nausea, vomiting, and lethargy for 1 day.DiagnosesHer blood sugar level was initially undetectable by the capillary blood glucose meter, and blood gas analysis showed severe DKA with elevated cardiac enzymes and prolonged QT interval.InterventionsThe patient was admitted to hospital and intensive intravenous fluid and regular insulin infusion were administered.OutcomesAfter 5 days of supportive care, the patient was fully recovered, discharged, and followed up in an outpatient clinic.LessonsSince the relationship between DKA and myocardial injury has not been clearly elucidated, pediatricians and emergency physicians should remain careful throughout the recovery time as it can lead to life-threatening conditions in various courses.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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