Aggressive Fluid Resuscitation in Severe Pediatric Hyperglycemic Hyperosmolar Syndrome: A Case Report

Murthy, Srinivas; Sharara‐Chami, Rana

doi:10.1155/2010/379063

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…After administration of insulin, the dosage should be titrated until the decrease of blood glucose reaches 75-100 mg/dL/ hour. 4,5,10 In this case, both of the patients received intravenous fluid with correction of dehydration. Both of the patients responded well to the fluid therapy with an improvement in dehydration status even though the fluid administration was based on diabetic ketoacidosis standardized treatment.…”

Section: Discussionmentioning

confidence: 98%

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Hyperglycemic hyperosmolar state in children: a case series

Lukman

Yuda

Arimbawa

2022

Intisari Sains Medis

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Background: Hyperglycemic hyperosmolar state (HHS) is a life-threatening rare acute complication of diabetes mellitus (DM). The condition should be distinguished from diabetic ketoacidosis (DKA) as the management differs significantly. HHS is classically associated with type 2 DM, but it has been increasingly reported in type I DM as well. The literature regarding HHS in children is still sparse. The management of HHS in children is extrapolated from the adult study. Cases: The first case was male 5 years old, and the second case was female 15 years old. Both cases were typed 1 DM patient. The first case was newly diagnosed. Both of the patients came with general weakness, mild dehydration, overly high blood sugar, normal blood pH, hypocalcemia, glucosuria and only mild ketonuria. In the second case develop, both patients were rehydrated, given insulin and discharged in 7-10 days without any sequelae. Conclusion: These case series emphasize the importance of recognizing HHS and differ it from DKA. These two cases prove that HHS is increasingly reported in children with clinical symptoms resembling DKA. It is also proven that with early diagnosis and correct management, children with HHS can be discharged home without any sequelae.

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Section: Discussionmentioning

confidence: 98%

“…A family history of diabetes mellitus in the family must be assessed. [5][6][7][8][9][10][11][12][13][14] In this case, there is no family history of diabetes mellitus in the first case, but there is a family history of diabetes mellitus in the grandmother and sibling of the patient in the second case.…”

Section: Case IImentioning

confidence: 99%

Hyperglycemic hyperosmolar state in children: a case series

Lukman

Yuda

Arimbawa

2022

Intisari Sains Medis

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“…This condition is not associated with a good prognosis, as reports indicate a mortality rate of 10–50% [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Hyperosmolar hyperglycemic state in children: case report and review of the literature

Shahramian

Rahimi

Radvar

2022

J. Klin. Endokrinol. Stoffw.

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Hyperosmolar hyperglycemic state (HHS) is a rare complication in children and a life-threatening emergency that presents with a significant increase in blood sugar and hyperosmolarity with or without low ketosis. This study reports the case of a 9-year-old boy with severe HHS due to type 1 diabetes. The patient’s initial serum glucose level was 1600; however, he was discharged in a stable condition. The patient presented many of the known complications of HHS, including decreased level of consciousness, hypovolemic shock, acute kidney injury, and very high serum glucose levels. The patient responded well to invasive fluid resuscitation and insulin administration, was discharged in good general condition without HHS-related complications, and was followed up with insulin therapy. As the prevalence of HHS in children is increasing, it is necessary for physicians to be aware of the unusual manifestations in children, especially children with type 1 diabetes, and to have the ability to diagnose and manage HHS and differentiate it from diabetic ketoacidosis.

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“…The existing literature on the association of HHS combined with type 1 DM is limited to a few case reports and small case series. However, the literature typically reports HHS without DKA overlap and normal or low sodium levels [ 8 - 10 ]. We report an adolescent female with new-onset type 1 DM presenting with mixed features of DKA and HHS.…”

Section: Introductionmentioning

confidence: 99%

A Rare Presentation of New-Onset Type 1 Diabetes Mellitus in a Developmentally Delayed Child With an Overlap of Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State

Villasmil¹,

Patel²,

Tansey³

et al. 2022

Cureus

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Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are serious complications associated with diabetes mellitus (DM). HHS is a common diagnosis in adults but rare in children. DKA is a usual presentation for new-onset type 1 DM, although HHS is rarely a manifestation of new-onset type 1 DM. Diagnosis and management of HHS are challenging in pediatric patients, especially if they present with a mixed picture of HHS and DKA. We report an adolescent female with a new onset of type 1 DM presented as mixed DKA and HHS. Treatment included meticulous management of fluids and continuous insulin drip with the resolution of acidosis within 24 hours and hyperosmolar state at 96 hours of admission. Early differentiation of these two entities and meticulous fluid management improves the outcome and decreases the risk of complications such as cerebral edema, renal failure, and thrombosis, among others.

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Aggressive Fluid Resuscitation in Severe Pediatric Hyperglycemic Hyperosmolar Syndrome: A Case Report

Cited by 4 publications

References 17 publications

Hyperglycemic hyperosmolar state in children: a case series

Hyperglycemic hyperosmolar state in children: a case series

Hyperosmolar hyperglycemic state in children: case report and review of the literature

A Rare Presentation of New-Onset Type 1 Diabetes Mellitus in a Developmentally Delayed Child With an Overlap of Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State

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