451: 13-Year-Old Male With Hyperglycemic Hyperosmolar Syndrome Complicated by Multiorgan System Failure

A 13-year-old male with ptosis.

A 13-year-old, previously healthy African-American male presented with a 12-hour history of double vision and inability to open his left eye. This was associated with 8 days of moderate to severe left temporal headache that was made worse by sunlight, television, and noise. He had also experienced intermittent nausea, vomiting, and fever over the prior 10 days. During the initial course of his ...

Hemophagocytic lymphohistiocytosis complicated by multiorgan failure

RATIONALE We present a case of hemophagocytic lymphohistiocytosis (HLH) with severe pulmonary complication and acute respiratory distress syndrome (ARDS) hospitalized in our intensive care unit (ICU) in 2014; distinctive trait of this case has been the challenging diagnosis, with a bone marrow biopsy always negative, the severe pulmonary complication with ARDS and severe pulmonary hypertension,...

Diabetic ketoacidosis and hyperglycemic hyperosmolar nonketotic syndrome.

Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNS) are life-threatening acute metabolic complications of diabetes mellitus. Although there are some important differences, the pathophysiology, the presenting clinical challenge, and the treatment of these metabolic derangements are similar. Each of these complications can be seen in type 1 or type 2 diabetes, al...

Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic Syndrome

(a) History: Most patients with diabetic ketoacidosis (DKA) or with hyperosmolar hyperglycemic state (HHS) will have a history of diabetes, and a history of altered insulin dose, infection, signifi cant medical “stress”. Antecedent symptoms of polyuria and polydipsia, lassitude, blurred vision, and mental status changes may predominate the clinical picture. With DKA, abdominal pain and tachypne...

Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar Syndrome