Hyperosmolar hyperglycemic state laboratory findings: Difference between revisions
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! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" + |VALUE IN HHS | ! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" + |VALUE IN HHS | ||
|- | |- | ||
| | |'''Plasma glucose (mg/dL)''' | ||
|N/A | |||
|< 200 mg/dl | |||
|> 600 mg/dl | |||
|- | |||
|Arterial ph | |||
| | | | ||
* [[Blood]] [[pH]] | * [[Blood]] [[pH]] | ||
| Line 38: | Line 43: | ||
* 7.35-7.45 | * 7.35-7.45 | ||
| | | | ||
* >7. | * > 7.30 | ||
|- | |- | ||
| colspan="1" rowspan="1" |[[Anion gap]] | | colspan="1" rowspan="1" |[[Anion gap]] | ||
| colspan="1" rowspan="1" | | | colspan="1" rowspan="1" | | ||
* | * (Na+) – (Cl– + HCO3–) | ||
| colspan="1" rowspan="1" | | | colspan="1" rowspan="1" | | ||
* | * 7 to 13 (mEq/L) | ||
| | | | ||
* | * Variable | ||
|- | |- | ||
| colspan="1" rowspan="1" |[[Osmolality|Serum osmolality]] | | colspan="1" rowspan="1" |[[Osmolality|Serum osmolality]] | ||
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* Increased (> 320mOsm/kg) | * Increased (> 320mOsm/kg) | ||
|- | |- | ||
|Plasma | |Plasma ketones | ||
| | | | ||
| | | | ||
|Trace or | |Trace or negative | ||
|- | |- | ||
| | |Urine ketones | ||
| | | | ||
| | | | ||
| | |Trace or negative | ||
|- | |- | ||
| | |Serum Bicarbonate | ||
| | | | ||
| | |23 - 29 mEq/L | ||
| | |> 18 mEq/L | ||
|- | |- | ||
|[[Blood urea nitrogen]], [[creatinine]] levels | |[[Blood urea nitrogen]], [[creatinine]] levels | ||
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| | | | ||
* N/A | * N/A | ||
|Increased | |||
| | | | ||
* | |||
* | |||
|} | |} | ||
==References== | ==References== | ||
Revision as of 20:17, 23 September 2017
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Hyperosmolar hyperglycemic state Microchapters |
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Differentiating Hyperosmolar hyperglycemic state from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].
OR
Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
OR
[Test] is usually normal among patients with [disease name].
OR
Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].
OR
There are no diagnostic laboratory findings associated with [disease name].
Laboratory Findings
The following lab abnormalities may be found in hyperosmolar hyperglycemic state (HHS):[1][2][3][4][5][6][7]
| LAB | FORMULA/ VARIABLE | NORMAL VALUE | VALUE IN HHS |
|---|---|---|---|
| Plasma glucose (mg/dL) | N/A | < 200 mg/dl | > 600 mg/dl |
| Arterial ph |
|
| |
| Anion gap |
|
|
|
| Serum osmolality |
|
| |
| Plasma ketones | Trace or negative | ||
| Urine ketones | Trace or negative | ||
| Serum Bicarbonate | 23 - 29 mEq/L | > 18 mEq/L | |
| Blood urea nitrogen, creatinine levels |
|
|
|
| Complete blood count (with differential) |
|
Increased |
|
References
- ↑ Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN (2009). "Hyperglycemic crises in adult patients with diabetes". Diabetes Care. 32 (7): 1335–43. doi:10.2337/dc09-9032. PMC 2699725. PMID 19564476.
- ↑ Chiasson JL, Aris-Jilwan N, Bélanger R, Bertrand S, Beauregard H, Ekoé JM, Fournier H, Havrankova J (2003). "Diagnosis and treatment of diabetic ketoacidosis and the hyperglycemic hyperosmolar state". CMAJ. 168 (7): 859–66. PMC 151994. PMID 12668546.
- ↑ Liamis G, Liberopoulos E, Barkas F, Elisaf M (2014). "Diabetes mellitus and electrolyte disorders". World J Clin Cases. 2 (10): 488–96. doi:10.12998/wjcc.v2.i10.488. PMC 4198400. PMID 25325058.
- ↑ Adrogué HJ, Lederer ED, Suki WN, Eknoyan G (1986). "Determinants of plasma potassium levels in diabetic ketoacidosis". Medicine (Baltimore). 65 (3): 163–72. PMID 3084904.
- ↑ Xu W, Wu HF, Ma SG, Bai F, Hu W, Jin Y, Liu H (2013). "Correlation between peripheral white blood cell counts and hyperglycemic emergencies". Int J Med Sci. 10 (6): 758–65. doi:10.7150/ijms.6155. PMC 3638300. PMID 23630441.
- ↑ Molitch ME, Rodman E, Hirsch CA, Dubinsky E (1980). "Spurious serum creatinine elevations in ketoacidosis". Ann. Intern. Med. 93 (2): 280–1. PMID 6773457.
- ↑ Gokel Y, Paydas S, Koseoglu Z, Alparslan N, Seydaoglu G (2000). "Comparison of blood gas and acid-base measurements in arterial and venous blood samples in patients with uremic acidosis and diabetic ketoacidosis in the emergency room". Am. J. Nephrol. 20 (4): 319–23. doi:13607 Check
|doi=value (help). PMID 10970986.