J Pediatr Endocrinol Metab. 2004 Mar.
Diabetic ketoacidosis secondary to growth hormone treatment in a boy with Prader-Willi syndrome and steatohepatitis.
Yigit S, Estrada E, Bucci K, Hyams J, Rosengren S.
Department of Pediatric Endocrinology and Diabetes, Connecticut Children 's Medical Center, Hartford, CT 06119, USA.
[ PubMed ]

Abstract: A 13 year-old boy with Prader-Willi syndrome and steatohepatitis presented with diabetic ketoacidosis 4 weeks after the initiation of growth hormone (GH) treatment. He did not have signs or symptoms of type 2 diabetes mellitus (DM2) before the initiation of GH treatment. Hyperglycemia resolved 2 months after discontinuation of GH. He redeveloped DM2 6 months later associated with excessive weight gain. Diabetic ketoacidosis as a rare complication of GH therapy emphasizes the importance of screening for carbohydrate intolerance before and during GH treatment in patients with Prader-Willi syndrome. Steatohepatitis may be the only manifestation of insulin resistance and warrants further evaluation.

[Note: Steatohepatitis is characterized by inflammation of the liver together with the accumulation of fat in the liver. It is classically found in alcoholics, but is also frequently found in people with diabetes and obesity, in which case it is called "non-alcoholic steatohepatitis" (NASH). Both types can progress to cirrhosis.]