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Non-ketotic hyperosmolar coma complicating steroid treatment in childhood nephrosis

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Two nephrotic children treated with prednisone developed steroid-induced diabetes and non-ketotic hyperosmolar coma (NKHC). Both patients presented with convulsions, coma and shock. The glucose concentration of the cerebrospinal fluid was 425 mg/dl and 622 mg/dl, respectively. Both patients had no diabetic family history, but had been treated with prednisone for 4 and 8 months, receiving total doses of 6.6 and 10.8 g, respectively. Despite conventional therapy, both patients deteriorated rapidly and died several hours later. Steroid-induced diabetes associated with NKHC is a rare but serious complication of steroid therapy.

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Yang, Jy., Xiao-lin Cui & He, Xj. Non-ketotic hyperosmolar coma complicating steroid treatment in childhood nephrosis. Pediatr Nephrol 9, 621–622 (1995).

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