An Emerging Challenge in Paediatric Obesity: A 13-year-old Boy with Life-threatening Hyperosmolar Hyperglycaemic Syndrome

Obesity is a pandemic health care issue that may cause not only morbidity but also mortality. We reported a case of a 13-year-old obese boy with newly diagnosed Type II diabetes mellitus presented with hyperosmolar hyperglycaemic syndrome (HHS) complicated by shock, acute renal insufficiency, acute pulmonary oedema and malignant hyperthermia-like syndrome. We alert practitioners for possible increasing incidence of HHS in obese adolescents in Hong Kong. Early recognition, aggressive fluid therapy, delay and insidious start of insulin, as well as use of dantrolene are possible strategies to reduce the morbidity and mortality of this syndrome.