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Hyperglycaemic hyperosmolar syndrome in children: Patient characteristics, diagnostic delays and associated complications
Author(s) -
Price Amanda,
Losek Joseph,
Jackson Benjamin
Publication year - 2016
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12980
Subject(s) - medicine , pediatrics , body mass index , diabetes mellitus , retrospective cohort study , surgery , endocrinology
Aims The aim of this study was to describe the demographical and clinical characteristics, diagnostic difficulties, and morbidity and mortality in children with hyperglycaemic hyperosmolar syndrome ( HHS ). Methods Retrospective cross‐section descriptive study of children (<18 years of age) at an urban, tertiary, academic C hildren's H ospital diagnosed with HHS from J anuary 2002 to D ecember 2011. Results Six patients met inclusion criteria for the diagnosis of HHS . Age ranged from 6 to 16 years with 4 (67%) patients younger than 13 years. Four (67%) patients were women and 5 (83%) were A frican‐ A merican. Body mass index ( BMI )‐for‐age percentile was >97% in four (67%) patients. Three (60%) of five patients seen as outpatients were misdiagnosed, two cases were seen twice before an accurate diagnosis of HHS was made. There was one (17%) death. Complications included three patients with acute renal failure, one patient with seizures, and one patient with rhabdomyolysis and compartment syndrome leading to below the knee amputation. Malignant hyperthermia and ventricular arrhythmias occurred in the patient who expired. Three of the five patients who had autoantibody tests had positive results and were diagnosed with type 1 diabetes mellitus. Conclusions Characteristics of children with HSS are variable for age, gender and BMI ‐for‐age percentile and not predominately limited to obese male adolescent A frican‐ A merican. Delay in diagnosis is common and morbidity and mortality in paediatric HHS are significant. The subsequent diagnosis of patients presenting with HHS includes type 1 and 2 diabetes mellitus.