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Unusual association of diseases/symptoms
Severe diabetic ketoacidosis leading to cardiac failure, pulmonary oedema and spinal cord oedema resulting in tetraplegia
  1. Michelle Christodoulidou1,
  2. Fahed Selmi2
  1. 1Department of Urology, Southport and Ormskirk Hospital NHS Trust, Southport, UK
  2. 2North West Spinal Injuries Unit, Southport and Ormskirk Hospital NHS Trust, Southport, UK
  1. Correspondence to Dr Michelle Christodoulidou, ematmichelle{at}


A 23-year-old man with poorly controlled insulin-dependent diabetes mellitus presented to casualty with community-acquired pneumonia and diabetic ketoacidosis. Shortly after admission he deteriorated and developed cardiac failure, pulmonary oedema and further decreased level of consciousness. He was sedated and ventilated for 3 weeks in the intensive care unit. On waking from sedation he was found to be tetraplegic. MRI scan showed gross oedema of the cervical spinal cord with area suspicious of infarction. We describe a rare cause of spinal cord injury and discuss the proposed hypotheses.

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