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Hyperglycaemic hyperosmolar syndrome in children: Patient characteristics, diagnostic delays and associated

Amanda Price1, Joseph Losek1, Benjamin Jackson1

  • 1Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, United States.

Journal of Paediatrics and Child Health
|August 1, 2015
PubMed

Insights

Hyperglycaemic hyperosmolar syndrome (HHS) in children presents with variable characteristics and often delayed diagnosis. Paediatric HHS leads to significant morbidity and mortality, underscoring the need for prompt recognition and management.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Metabolic Disorders

Background:

  • Hyperglycaemic hyperosmolar syndrome (HHS) is a serious diabetic emergency.
  • Understanding paediatric HHS characteristics is crucial for timely diagnosis and management.

Purpose of the Study:

  • To delineate the demographic and clinical features of paediatric HHS.
  • To identify diagnostic challenges and assess morbidity/mortality associated with paediatric HHS.

Main Methods:

  • Retrospective descriptive study.
  • Analysis of children (<18 years) diagnosed with HHS between 2002-2011 at a tertiary children's hospital.

Main Results:

  • Six paediatric HHS cases identified; age 6-16 years, predominantly female (67%) and African-American (83%).
  • Obesity (BMI >97th percentile) noted in 67%. Misdiagnosis occurred in 60% of outpatients.
  • Complications included acute renal failure, seizures, rhabdomyolysis, and one death (malignant hyperthermia, ventricular arrhythmias).

Conclusions:

  • Paediatric HHS demographics are diverse, not limited to obese, male adolescents.
  • Delayed diagnosis is frequent, contributing to significant morbidity and mortality.
  • HHS in children can be associated with both type 1 and type 2 diabetes mellitus.
Abstract

Keywords:
hyperglycaemic hyperosmolar syndromepaediatrics

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