Hyperosmolar coma which is characterized by severe hyperglycemia in absence
of chetosis is very rare in pediatric age with only 11 cases reported in t
he literature. The outcome of the condition is usually poor with mental ret
ardation being the most common event. Here a case of hyperosmolar coma is d
escribed in a female of three months of age who was treated with peritoneal
dialysis 11 hours after admittance to hospital. This female patient has be
en receiving insulin from three months of age and today at the age of 10 ye
ars she leads a normal life despite being on insulin therapy. A very low le
vel of C-peptide (<0.3 ng/ml) clearly confirms she is affected by Type 1 di
abetes. To our knowledge this is the first case report of hyperosmolar coma
in a neonate with Type 1. diabetes who survived this condition without lat
e neurological consequences. (C)2001. Editrice Kurtis.