Hyperosmolarity and non-ketotic hyperglycemia.
DOI:
https://doi.org/10.20344/amp.4172Abstract
Descrevem-se oito casos da síndrome de hiperosmolalidade com hiperglicemia grave não cetónica, na ausência de estado de coma. No início da terapêutica, observaram-se os seguintes exames laboratoriais: glicemia 1127 (700-1700) mg/100 ml; osmolalidade 364 (326--376) mOsm/Kg; sódio 136 (112-148) mEq/L; potássio 4,2 (1,9-5,7) mEq/L; e ureia 55 (19-110) mg/100 ml; gIicosúria ♦♦♦♦ e cetonúria O/+. O valor mais elevado de glicemia, 1700 mg/100 ml, foi observado num doente com diabetes lipoatrofica. Outras doenças associadas: pielonefrite aguda, piodermite necrosante e pancreatite crónica. Quatro doentes tinham historia prévia de diabetes mellitus. Os sintomas predominantes foram: polidipsia, poliuria e astenia. Em três doentes ocorreram convulsões. Todos os doentes recuperaram em consequência da rápida reposição de líquidos e eletrólitos, associada a terapêutica com insulina e correcção dos factores precipitantes.
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