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Hyponatremia with an Osmolar Gap, Pseudohyponatremia or Hyper-Osmolar Hyponatremia?
Am J Med Open
June 2025
Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, Tex.
Pseudohyponatremia is frequently misunderstood and often mistaken for other types of hyponatremia. In this study, we present a case of pseudohyponatremia resulting from hypertriglyceridemia. We provide an in-depth analysis of the pathophysiological mechanisms involved, comparing them with those of other hyponatremic disorders, and outline the diagnostic approach used to identify this atypical form of hyponatremia.
View Article and Find Full Text PDFQuantifying the Deficits of Body Water and Monovalent Cations in Hyperglycemic Emergencies.
J Clin Med
December 2024
Research Service, Department of Medicine, Raymond G. Murphy Veterans Affairs Medical Center, University of New Mexico School of Medicine, Albuquerque, NM 87108, USA.
Hyperglycemic emergencies cause significant losses of body water, sodium, and potassium. This report presents a method for computing the actual losses of water and monovalent cations in these emergencies. We developed formulas for computing the losses of water and monovalent cations as a function of the presenting serum sodium and glucose levels, the sum of the concentrations of sodium plus potassium in the lost fluids, and body water at the time of hyperglycemia presentation as measured by bioimpedance or in the initial euglycemic state as estimated by anthropometric formulas.
View Article and Find Full Text PDFDiazoxide-Associated Hyperglycemia: A Critical Case Precipitating Hyperosmolar Hyperglycemic State in a Child.
J Med Toxicol
January 2025
Division of Pediatric Emergency Medicine, Johns Hopkins Children's Center, 1800 Orleans Street, Baltimore, MD, 21287, USA.
Introduction: Diazoxide is the first-line treatment for children with hyperinsulinemic hypoglycemia (HI). In these cases, diazoxide raises blood glucose levels by suppressing insulin release, preventing hypoglycemia, and potentially devastating end-organ sequelae. Hyperosmolar hyperglycemic state (HHS) is an exceedingly rare side effect of diazoxide.
View Article and Find Full Text PDFAcute hyperglycemic hyperosmolar syndrome associated with capivasertib, a new, oral targeted therapy for advanced breast cancer.
Am J Emerg Med
December 2024
Department of Emergency Medicine, Sharp Grossmont Hospital, La Mesa, CA, United States.
Capivasertib is a new targeted therapy for the treatment of select cases of hormone receptor positive, HER2 negative advanced breast cancer. Hyperglycemia is a known adverse effect of capivasertib with a 16 % incidence rate, however life-threatening hyperglycemia occurs rarely (incidence 0.3 %).
View Article and Find Full Text PDFA nested case-control study of adverse outcomes in children with diabetic ketoacidosis.
J Clin Endocrinol Metab
December 2024
Division of Pediatric Endocrinology, Department of Pediatrics, UT Southwestern Medical Center, Dallas TX.
Background: Adverse Outcomes (death or ICU stays longer than 48h) in children with diabetic ketoacidosis (DKA) or hyperglycemic-hyperosmolar syndrome (HHS) can be predicted by a composite risk score based on severity of hyperglycemia and acidosis, and presence of type 2 diabetes. Because most high-risk patients nevertheless do not experience an Adverse Outcome, we tried to identify differences in management or other clinical characteristics that influenced outcomes.
Methods: In a previously defined group of 4565 admissions for DKA-HHS in 2010-2023, 109 had Adverse Outcomes.
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