JHM Young, MK Tay, DCY Lau, KF Huen

Abstract

Obesity is a pandemic health care issue that may cause not only morbidity but also mortality. We reported a case of a 13-year-old obese boy with newly diagnosed Type II diabetes mellitus presented with hyperosmolar hyperglycaemic syndrome (HHS) complicated by shock, acute renal insufficiency, acute pulmonary oedema and malignant hyperthermia-like syndrome. We alert practitioners for possible increasing incidence of HHS in obese adolescents in Hong Kong. Early recognition, aggressive fluid therapy, delay and insidious start of insulin, as well as use of dantrolene are possible strategies to reduce the morbidity and mortality of this syndrome.

肥胖是一種近代流行的醫療問題，不但可能引發多種疾病，而且可以致命。我們報導一名13歲的肥胖男孩初診II型糖尿病表現為高滲透高血糖綜合徵（HHS）伴有休克，急性腎功能不全，急性肺水腫和惡性高熱樣綜合徵。我們提醒臨床醫生，香港肥胖青少年的HHS發病率越來越高。早期識別、積極補液治療、推遲首次應用胰島素的時間，以及使用丹曲林，是減少這種綜合徵的發病率和死亡率的策略。