Abstract
Objective. This report describes a severe case of hyperglycemic hyperosmolar syndrome complicated by rhabdomyolysis, acute kidney injury, hyperthermia, and hypovolemic shock, with management centred upon fluid administration. Design. Case report. Setting. Pediatric intensive care unit in university teaching hospital. Patients. 12 years old adolescent female presenting with hyperglycemic hyperosmolar syndrome with a new diagnosis of type 2 diabetes mellitus. Intervention. Aggressive fluid resuscitation and insulin. Main results. The patient had a good outcome, discharged home on hospital day 6. Conclusions. Hyperglycemic hyperosmolar syndrome is associated with a number of complications. Management strategies are undefined, given the rarity of its presentation, and further studies are warranted.
Highlights
Recent trends indicate a rising percentage of type two diabetes in the under eighteen population, with a prevalence of 0.22 cases per 1000 youth [1] amongst the American population
A formal distinction between Hyperglycemic hyperosmolar syndrome (HHS) and diabetic ketoacidosis (DKA) exists, with DKA typically presenting with lower levels of hyperglycemia, ketosis, and more significant metabolic acidosis, these two illnesses are more likely on the spectrum of decompensations related to diabetes [2]
She maintained an intact neurological examination throughout her hospitalization. She was transferred to the regular floor after a 60 hours PICU admission, and was discharged home on a glargine-containing insulin regimen after a total six-day hospital course. This patient presented with HHS as a complication of newly diagnosed type 2 diabetes mellitus
Summary
This report describes a severe case of hyperglycemic hyperosmolar syndrome complicated by rhabdomyolysis, acute kidney injury, hyperthermia, and hypovolemic shock, with management centred upon fluid administration. Pediatric intensive care unit in university teaching hospital. 12 years old adolescent female presenting with hyperglycemic hyperosmolar syndrome with a new diagnosis of type 2 diabetes mellitus. The patient had a good outcome, discharged home on hospital day 6. Hyperglycemic hyperosmolar syndrome is associated with a number of complications. Management strategies are undefined, given the rarity of its presentation, and further studies are warranted
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