INTRODUCTION: Isolated Hyperosmolar Hyperglycaemic Syndrome (HHS) is a life-threatening condition characterized by elevated serum glucose concentrations and hyperosmolality without significant ketosis. It is often described in obese adults with unknown Type 2 Diabetes (T2D), rarely in youth. In childhood the most common cause of metabolic glucose related derangement is Diabetic Ketoacidosis (DKA) in Type 1 Diabetes (T1D). Interestingly, both components can be combined with each other, thus the prevalent condition needs to be recognised implying a different therapeutic approach. CASE PRESENTATION: In this case, we report a prepubertal Caucasian obese girl admitted for two episodes of combined HHS/DKA in order to elucidate her clinical course taking into account the current pediatric recommendations based on adult guidelines for HHS. CONCLUSIONS: The treatment of HHS and even more of HHS/DKA in youth is still controversial as no specific guidelines for children are available especially during the prepubertal age. The description of our case might be helpful and offer relevant points for future consensus.
INTRODUCTION:Isolated Hyperosmolar Hyperglycaemic Syndrome (HHS) is a life-threatening condition characterized by elevated serum glucose concentrations and hyperosmolality without significant ketosis. It is often described in obese adults with unknown Type 2 Diabetes (T2D), rarely in youth. In childhood the most common cause of metabolic glucose related derangement is Diabetic Ketoacidosis (DKA) in Type 1 Diabetes (T1D). Interestingly, both components can be combined with each other, thus the prevalent condition needs to be recognised implying a different therapeutic approach. CASE PRESENTATION: In this case, we report a prepubertal Caucasian obesegirl admitted for two episodes of combined HHS/DKA in order to elucidate her clinical course taking into account the current pediatric recommendations based on adult guidelines for HHS. CONCLUSIONS: The treatment of HHS and even more of HHS/DKA in youth is still controversial as no specific guidelines for children are available especially during the prepubertal age. The description of our case might be helpful and offer relevant points for future consensus.
Entities:
Keywords:
Case Report; Diabetic Ketoacidosis; Hyperglycaemic hyperosmolar state; Obese children; Type 2 Diabetes
Authors: Elizabeth J Mayer-Davis; Jean M Lawrence; Dana Dabelea; Jasmin Divers; Scott Isom; Lawrence Dolan; Giuseppina Imperatore; Barbara Linder; Santica Marcovina; David J Pettitt; Catherine Pihoker; Sharon Saydah; Lynne Wagenknecht Journal: N Engl J Med Date: 2017-04-13 Impact factor: 91.245
Authors: Joseph I Wolfsdorf; Nicole Glaser; Michael Agus; Maria Fritsch; Ragnar Hanas; Arleta Rewers; Mark A Sperling; Ethel Codner Journal: Pediatr Diabetes Date: 2018-10 Impact factor: 4.866
Authors: Georgeanna J Klingensmith; Crystal G Connor; Katrina J Ruedy; Roy W Beck; Craig Kollman; Heidi Haro; Jamie R Wood; Joyce M Lee; Steven M Willi; Eda Cengiz; William V Tamborlane Journal: Pediatr Diabetes Date: 2015-05-08 Impact factor: 4.866
Authors: Michael F Canarie; Clifford W Bogue; Kenneth J Banasiak; Stuart A Weinzimer; William V Tamborlane Journal: J Pediatr Endocrinol Metab Date: 2007-10 Impact factor: 1.634