Nonketotic hyperosmolar syndrome as an acute complication of type 1 diabetes onset in a 20-month-old boy with congenital central nervous system defect

Hyperglycemic hyperosmolar syndrome (HHS) is one of the most severe acute complications of type 2 diabetes, but may also be developed in type 1 diabetes. Similar to ketoacidosis,HHS still remains one of the major causes of morbidity and mortality in patients with diabetes,despite a significant progress in understanding its pathogenesis and greater consensus on HHS diagnosis and treatment. It is mainly observed in elderly patients with type 2 diabetes. However,it may also occur in children,especially in infants and those with concomitant central nervous system (CNS) defects or suffering from severe infections associated with dehydration. The authors report a case of HHS in a 20-month-old child with central nervous system abnormality. Symptoms observed in our patient are characteristic for HHS. It must be emphasized that HHS may accompany diabetes onset also in children.