Metabolism
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Muscle weakness and hypoketotic coma on fasting
TFP is a 3 year old girl who was admitted to the Emergency Department of her local hospital in a coma after two days when she had a fever and had been refusing food. She has a history of muscle weakness, and at the time of her admission her muscle tone was very poor - she was described as being "floppy". A blood sample taken on admission gave the following results:
TFP |
reference range (after overnight fast) |
|
| glucose (mmol /L) | 2.1 mmol /L |
3.5 - 5.5 |
| non-esterified fatty acids (mmol /L) | 2.5 mmol /L |
0.8 - 1.4 |
| ketone bodies (mmol /L) | not detectable |
1.0 - 2.5 |
| pH | 7.40 |
7.35 - 7.45 |
| bicarbonate | 23 |
21 - 25 |
| insulin (mU /L) | 3.5 |
4 - 8 |