Related Experiment Video
Updated: Jun 3, 2026
09:35
A Mouse Model of Hemorrhagic Transformation Induced by Acute Hyperglycemia Combined with Transient Focal Ischemia
Published on: November 15, 2024
Hyperosmolar hyperglycemic syndrome with rhabdomyolysis
Mary E Stunkard1, Valerie T Pikul, Kevin Foley
1Department of Clinical Sciences, Northern Michigan University, Marquette, MI 49855, USA. mstunkar@nmu.edu
Summary
This case report details a patient with severe hyperglycemia, experiencing nausea, vomiting, and mental impairment. The patient developed rhabdomyolysis and myocardial infarction due to nonketotic hyperosmolar hyperglycemia.
Area of Science:
- Internal Medicine
- Endocrinology
- Cardiology
Background:
- Nonketotic hyperosmolar hyperglycemia (NKH) is a serious diabetic complication.
- Rhabdomyolysis and myocardial infarction are severe conditions with significant morbidity.
- The co-occurrence of these conditions presents a diagnostic and therapeutic challenge.
Observation:
- A patient presented with gastrointestinal distress, tachypnea, and altered mental status.
- Laboratory findings revealed severe hyperglycemia (> 2000 mg/dl) without ketonuria.
- Elevated markers of muscle and cardiac injury (lipase, troponin-I, creatinine kinase, myoglobin) were noted.
Findings:
- The patient was diagnosed with nonketotic hyperosmolar hyperglycemia.
- Concomitant rhabdomyolysis and myocardial infarction were identified in this patient.
- The absence of ketonuria in severe hyperglycemia is a key diagnostic feature.
Implications:
- This case highlights the potential for severe hyperglycemia to trigger multi-organ complications.
- Early recognition and management of NKH are crucial to prevent adverse outcomes.
- Understanding the link between hyperglycemia and conditions like rhabdomyolysis and myocardial infarction is vital for clinical practice.
Related Concept Videos
01:21Hyperosmolar Hyperglycemic State
Hyperosmolar Hyperglycemic State, or HHS, is a serious and life-threatening complication of type 2 diabetes mellitus. It is characterized by three main features: severe hyperglycemia, profound dehydration, and elevated serum osmolality, all occurring without significant ketoacidosis.HHS typically develops in older adults or individuals with limited access to fluids. This may result from illness, cognitive impairment, or medications such as diuretics or corticosteroids. These factors reduce...
01:29Hyperglycemia
Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
01:22Diabetic Ketoacidosis ll: Pathophysiology
Diabetic ketoacidosis (DKA) is a metabolic emergency characterized by hyperglycemia, ketonemia, and metabolic acidosis. It results from severe insulin deficiency and an excess of counterregulatory hormones, leading to uncontrolled lipolysis, ketogenesis, and widespread electrolyte and fluid disturbances.Pathophysiology The central event in DKA is a profound loss of insulin action. Without insulin, glucose uptake in insulin-dependent tissues is impaired, while hepatic glucose production...
01:25Diabetic Ketoacidosis l: Introduction
DefinitionDiabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes mellitus, characterized by a triad of hyperglycemia (blood glucose >250 mg/dL), ketonemia or ketonuria, and metabolic acidosis (arterial pH <7.30 and serum bicarbonate <18 mEq/L). It results from insulin deficiency combined with elevated levels of counterregulatory hormones—glucagon, catecholamines, cortisol, and growth hormone—leading to increased lipolysis, hepatic ketone production, and...
01:26Hypoglycemia
Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
01:15Hypoglycemia and Glucagon
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...