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Updated: Feb 19, 2026
08:31
Murine Model of Leukemia Relapse to Induction Chemotherapy for Acute Lymphoblastic Leukemia
Published on: October 17, 2025
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Hyperglycemic Hyperosmolar State During Induction Chemotherapy for Acute Lymphoblastic Leukemia.
Pediatric Emergency Care
|November 3, 2017
Summary
A rare case of hyperosmolar hyperglycemic state (HHS) occurred in a teen with acute lymphoblastic leukemia (ALL) undergoing chemotherapy. Prompt fluid resuscitation and insulin therapy are crucial to manage this life-threatening condition.
Area of Science:
- Pediatric Oncology
- Endocrinology
- Hematology
Background:
- Acute lymphoblastic leukemia (ALL) treatment often involves chemotherapy regimens.
- Chemotherapy agents like glucocorticoids and asparaginase can induce hyperglycemia.
- Hyperosmolar hyperglycemic state (HHS) is a rare but serious complication in pediatric ALL patients.
Observation:
- A 16-year-old boy with relapsed ALL presented with symptoms of fatigue, polyuria, and polydipsia.
- Blood gas analysis confirmed hyperosmolar hyperglycemic state.
- The hyperglycemia was attributed to combined oral glucocorticoid and asparaginase therapy.
Findings:
- The patient received aggressive saline rehydration and medications for hyperkalemia.
- Continuous insulin infusion was used to gradually normalize blood glucose levels.
- Successful management of HHS was achieved with a multi-faceted approach.
Implications:
- Frontline providers must recognize HHS as a potential complication in ALL patients.
- Inadequate fluid resuscitation before correcting hyperglycemia can lead to hypovolemic shock.
- Awareness and prompt management are critical to prevent mortality in pediatric oncology patients with HHS.
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