Abstract
A case of hyperosmolar nonketotic diabetic coma in 18 years old man with no history of diabetes mellitus was described.
Laboratory data: blood glucose 1, 320 mg. per 100 ml; serum sodium 140, potassium 6.9, calcium 3.7 mEq. per liter ; NPN 91.4 mg. per 100 ml ; total cholesterol97 mg per 100 ml ester ratio 46.4%; GOT 46 U, GPT 26U ; Amylase in serum 8 U, in urine 4 U; total protein 9.5 g per 100 ml ; alb. 46.1%, gamma-gl. 22.3%; urine: protein 2+, sugar 4+, no ketones. Estimate gave a value of 382 milliosmoles per liter.
In this syndrome it is unusual that he was a young man and had no hypernatremia. He had, however, extreme hyperglycemia and hyperosmolarity, further no ketones in urine and low serum cholesterol level. He died from diabetic coma, circulatory disturbance and hemorrhagic diathesis on the 7th day in hospital.
In autopsy pancreas was small and islands were found small in number, and about them it seemed to be congenital anomaly. Kidney had only a little pathological change. In liver markedly fatty degeneration was found. In our case the finding of fatty liver with hypocholesterolemia was of interested from the view point of nonketotic state and fatty metabolism.
