Thiamine deficiency-related myocardial dysfunction: A hidden cause of refractory lactic acidosis and shock in severe diabetic ketoacidosis: A case report
Bibliographic record
Abstract
Abstract Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus, characterized by hyperglycemia, ketosis, and metabolic acidosis. Severe dehydration and hypovolemic shock in severe DKA are common, but myocardial dysfunction and lactic acidosis are rare. We report a case of an adolescent female who presented with severe DKA in refractory shock, requiring vasoactive support and mechanical ventilation. Myocardial dysfunction and persistent lactic acidosis led to the suspicion of thiamine deficiency. There was a remarkable recovery after administration of intravenous thiamine. This case highlights the importance of suspecting thiamine deficiency-related myocardial dysfunction and lactic acidosis in children with DKA not responding to usual therapy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".