Approach to management of malignant hyperthermia-like syndrome in pediatric diabetes mellitus

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
Brendan J KilbaneNancy A Crimmins

Abstract

Hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is usually associated with type 2 diabetes mellitus and is rare in children. However, a fatal malignant hyperthermia-like syndrome (MHLS) with rhabdomyolysis associated with new-onset diabetes mellitus and HHNS in adolescents has been described. Case series. A 16-yr-old obese male (case A) and a 10-yr-old mid-pubertal nonobese female (case B) presented within a 6-month period with emesis, altered mental status, blood glucose >1600 mg/dL, and laboratory evidence of rhabdomyolysis. Case A developed fever after initiation of insulin therapy, along with refractory hypotension and multiorgan failure. He died 14 hrs after admission. Case B developed fever before insulin therapy, was treated with dantrolene, and made a full recovery. Metabolic workup showed evidence of short-chain acyl-CoA dehydrogenase (SCAD) deficiency. We report two cases of malignant hyperthermia-like syndrome associated with HHNS in adolescents. Their respective fluid management and clinical courses are described. Dantrolene therapy should be initiated immediately after this syndrome is recognized. We believe it is unlikely insulin is the sole trigger for MHLS. Case B is unique in that there was evidence of SC...Continue Reading

References

Feb 1, 1979·American Journal of Diseases of Children·S L Goldman
Feb 1, 1975·American Journal of Diseases of Children·F Ginsberg-Fellner, W A Primack
Jan 1, 1990·Diabetes Care·A L Rosenbloom
Oct 16, 1989·The Medical Journal of Australia·P S HamblinJ R Stockigt
Apr 1, 1986·Diabetologia·J Møller-PetersenJ Ditzel
Mar 1, 1985·Diabetes Care·E Schlepphorst, M E Levin
Apr 1, 1974·The Journal of Pediatrics·F Fernandez, E R Hughes
Feb 1, 1969·The Journal of Pediatrics·H M RubinA Drash
Mar 23, 1967·The New England Journal of Medicine·R M Ehrlich, H W Bain
Dec 1, 1967·American Journal of Diseases of Children·M D Kogut, B H Landing
Feb 1, 1981·American Journal of Diseases of Children·B A BuckinghamM D Kogut
Dec 31, 1994·Diabetes Research and Clinical Practice·L M WangC H Lee
Jan 1, 1994·Postgraduate Medical Journal·D TrumpP Sharp
Aug 1, 1996·Intensive Care Medicine·F WapplerJ Schulte am Esch
Oct 23, 1997·Critical Care Clinics·T C ChanR F Clark
Jan 10, 2001·Endocrinology and Metabolism Clinics of North America·M F DelaneyW M Kettyle
Feb 15, 2001·The New England Journal of Medicine·N GlaserUNKNOWN Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics
Jul 13, 2001·JAMA : the Journal of the American Medical Association·J R TobinN Sambuughin
Dec 28, 2002·Diabetes Care·Abbas E KitabchiUNKNOWN American Diabetes Association
Feb 5, 2004·The Journal of Pediatrics·Alba E Morales, Arlan L Rosenbloom
Aug 4, 2004·The Journal of Pediatrics·Nicole S GlaserNathan Kuppermann
Jan 8, 2005·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Rebecca M CarchmanBradford D Harris

❮ Previous
Next ❯

Citations

Apr 18, 2008·Pediatric Emergency Care·Raemma Paredes Luck, Sandi Verbin
Nov 3, 2010·The Journal of Pediatrics·Phil ZeitlerUNKNOWN Drugs and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society
Jan 29, 2010·The Journal of Pediatrics·Arlan L Rosenbloom
Aug 29, 2012·Pediatric Diabetes·Dayanand BagdureMarion R Sills
Feb 3, 2012·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Marlies Frank, Josef Finsterer
Dec 7, 2007·Journal of Pediatric Endocrinology & Metabolism : JPEM·Michael F CanarieWilliam V Tamborlane
Aug 24, 2019·Current Diabetes Reports·Ishita KharodeZoltan Antal
Sep 29, 2020·Frontiers in Medicine·Todd S IngAntonios H Tzamaloukas

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
Fredrik AhlssonPer Enblad
© 2021 Meta ULC. All rights reserved