[In-hospital cardiac arrest due to unobserved steroid-induced hyperglycaemic hyperosmolar syndrome]

The merging of hospital wards into highly specialized units facilitates targeted diagnostics and treatment. Often the result is favourable for the patient, but in some cases the basic conditions are overlooked. We describe a patient with inoperable oesophageal cancer who had unexplained mental confusion for three days due to an unobserved corticosteroid-induced hyperglycaemic hyperosmolar syndrome. The main differential diagnosis was cerebral metastases and a cerebral computed tomography was performed before cardiac arrest led to the right diagnosis. It is crucial to remember that unexplained deterioration in a patient with inoperable cancer can have a reversible cause.