Abstracts

RATIONALE: The ketogenic diet has demonstrated good efficacy in children with pharmacologically resistant seizures. Relatively few serious complications have been reported in the >70 years the diet has been used. We report a child who developed acute pancreatitis and died. METHODS: A 9 year old girl had a seizure disorder with associated developmental delay due to glucose transport deficiency. The ketogenic diet with MCT oil had been initiated shortly after diagnosis in infancy. She was on no anticonvulsants. She presented in coma with decreased respiratory effort and shock, requiring resuscitation. Investigations showed hypocalcemia, hyperphosphatemia, hypoalbuminemia and markedly elevated amylase, consistent with pancreatitis. RESULTS: Despite fluid resuscitation and inotropic support, she remained acidotic and hypocalcemic. She subsequently arrested and died. Post mortem examination confirmed hemorrhagic pancreatitis. CONCLUSIONS: Hypertriglyceridemia is a risk factor for developing acute pancreatitis. The high fat content of the ketogenic diet may predispose patients to hyperlipidemia, particularly over long periods of time, as in the patient presented. The outcome for this patient raises concern regarding a potential consequence of the ketogenic diet.