Steroid‐Induced Hyperosmolar Hyperglycemic Syndrome in a Young Patient Without Diabetes After Treating Him for Minimal Change Disease—Case Report
ABSTRACT Hyperosmolar hyperglycemic syndrome (HHS) is a common complication of diabetes mellitus. The episodes of HHS have been reported in patients with no prior history of diabetes. However, these incidents have rarely been reported in the literature. The present study reports the case of hyperosm...
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Wiley
2024-11-01
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| Online Access: | https://doi.org/10.1002/ccr3.9599 |
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| author | Rehab B. Albakr |
| author_facet | Rehab B. Albakr |
| author_sort | Rehab B. Albakr |
| collection | DOAJ |
| description | ABSTRACT Hyperosmolar hyperglycemic syndrome (HHS) is a common complication of diabetes mellitus. The episodes of HHS have been reported in patients with no prior history of diabetes. However, these incidents have rarely been reported in the literature. The present study reports the case of hyperosmolar hyperglycemic syndrome in a patient without diabetes history after being prescribed high‐dose steroid therapy. This case highlights the importance of regularly monitoring blood glucose levels in patients prescribed supraphysiological doses of steroids. The present study presents a 29‐year‐old male patient with no previous history of diabetes who presented with HHS, manifested by a decreased level of consciousness, lethargy, and history of polyuria. Laboratory work revealed significantly high serum glucose and high serum osmolality, with no ketones. Two weeks prior to the presentation, the patient was started on 1 mg/kg of oral prednisolone for his new diagnosis of minimal change disease with a nephrotic syndrome picture. The management of HHS included aggressive fluid intake and insulin therapy, and the steroid was tapered quickly. Hyperglycemia resolved completely with normalization of his HbA1c after the complete stoppage of steroids and he did not require to continue lifelong insulin. The present study highlights the importance of assessing the risk of hyperglycemia, screening, and regular glucose monitoring in patients prescribed supraphysiological doses of steroids, even if no prior history of diabetes has been recorded.. |
| format | Article |
| id | doaj-art-9f569bf89cbd409fb91f40a90f799fee |
| institution | DOAJ |
| issn | 2050-0904 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wiley |
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| series | Clinical Case Reports |
| spelling | doaj-art-9f569bf89cbd409fb91f40a90f799fee2025-08-20T02:49:46ZengWileyClinical Case Reports2050-09042024-11-011211n/an/a10.1002/ccr3.9599Steroid‐Induced Hyperosmolar Hyperglycemic Syndrome in a Young Patient Without Diabetes After Treating Him for Minimal Change Disease—Case ReportRehab B. Albakr0Division of Nephrology, Department of Medicine, College of Medicine King Saud University Riyadh Saudi ArabiaABSTRACT Hyperosmolar hyperglycemic syndrome (HHS) is a common complication of diabetes mellitus. The episodes of HHS have been reported in patients with no prior history of diabetes. However, these incidents have rarely been reported in the literature. The present study reports the case of hyperosmolar hyperglycemic syndrome in a patient without diabetes history after being prescribed high‐dose steroid therapy. This case highlights the importance of regularly monitoring blood glucose levels in patients prescribed supraphysiological doses of steroids. The present study presents a 29‐year‐old male patient with no previous history of diabetes who presented with HHS, manifested by a decreased level of consciousness, lethargy, and history of polyuria. Laboratory work revealed significantly high serum glucose and high serum osmolality, with no ketones. Two weeks prior to the presentation, the patient was started on 1 mg/kg of oral prednisolone for his new diagnosis of minimal change disease with a nephrotic syndrome picture. The management of HHS included aggressive fluid intake and insulin therapy, and the steroid was tapered quickly. Hyperglycemia resolved completely with normalization of his HbA1c after the complete stoppage of steroids and he did not require to continue lifelong insulin. The present study highlights the importance of assessing the risk of hyperglycemia, screening, and regular glucose monitoring in patients prescribed supraphysiological doses of steroids, even if no prior history of diabetes has been recorded..https://doi.org/10.1002/ccr3.9599diabetesglomerulonephritishyperglycemic hyperosmolar syndromeminimal change diseasesteroid |
| spellingShingle | Rehab B. Albakr Steroid‐Induced Hyperosmolar Hyperglycemic Syndrome in a Young Patient Without Diabetes After Treating Him for Minimal Change Disease—Case Report Clinical Case Reports diabetes glomerulonephritis hyperglycemic hyperosmolar syndrome minimal change disease steroid |
| title | Steroid‐Induced Hyperosmolar Hyperglycemic Syndrome in a Young Patient Without Diabetes After Treating Him for Minimal Change Disease—Case Report |
| title_full | Steroid‐Induced Hyperosmolar Hyperglycemic Syndrome in a Young Patient Without Diabetes After Treating Him for Minimal Change Disease—Case Report |
| title_fullStr | Steroid‐Induced Hyperosmolar Hyperglycemic Syndrome in a Young Patient Without Diabetes After Treating Him for Minimal Change Disease—Case Report |
| title_full_unstemmed | Steroid‐Induced Hyperosmolar Hyperglycemic Syndrome in a Young Patient Without Diabetes After Treating Him for Minimal Change Disease—Case Report |
| title_short | Steroid‐Induced Hyperosmolar Hyperglycemic Syndrome in a Young Patient Without Diabetes After Treating Him for Minimal Change Disease—Case Report |
| title_sort | steroid induced hyperosmolar hyperglycemic syndrome in a young patient without diabetes after treating him for minimal change disease case report |
| topic | diabetes glomerulonephritis hyperglycemic hyperosmolar syndrome minimal change disease steroid |
| url | https://doi.org/10.1002/ccr3.9599 |
| work_keys_str_mv | AT rehabbalbakr steroidinducedhyperosmolarhyperglycemicsyndromeinayoungpatientwithoutdiabetesaftertreatinghimforminimalchangediseasecasereport |