HYPEROSMOLAR NONKETOTIC COMA AT THE ONSET OF TYPE-I DIABETES IN A CHILD

A 12 yr-old child without any past medical history of diseases was adm itted to hospital for sopor and polyuria. At admission he was markedly dehydrated. Blood glucose was 72 mmol/l, sodium 154 mmol/l, osmolarit y 381 mOsm/Kg, urinary ketons were negative. He was rehydrated with hy potonic saline and treated with insulin. The osmolality and sodium ini tially increased to 176 mmol/l and 408 mOsm/Kg respectively and progre ssively decreased to normal levels. Serum transaminases increased to G OT 336 and GPT 209 U/l in the first days of treatment and normalized a fter 15 days. The anti-islet antibodies were positive. The non ketotic hyperosmolar coma and Type I diabetes is rare in children but this po ssibility must be kept in mind especially when some familial or psycho logical problems are present as in our case. (C) 1997, Editrice Kurtis .