Article: article from journal or magazin.
Case report (case report): feedback on an observation with a short commentary.
Haemorrhagic shock and encephalopathy syndrome: report of two cases with special reference to hypoglycaemia.
Schweizerische medizinische Wochenschrift
Publication types: Case Reports ; Journal Article - Publication Status: ppublish
Haemorrhagic shock and encephalopathy syndrome (HSES) is a devastating disorder affecting infants. So far no cases have been reported in Switzerland. It is characterised by the abrupt onset of hyperpyrexia, shock, encephalopathy, diarrhoea, disseminated intravascular coagulation (DIC) and renal and hepatic failure in previously healthy infants. Severe hypoglycaemia has been repeatedly reported in association with HSES. However, the pathophysiology of the hypoglycaemia is not clear. We report on two infants (2 and 7 months old) with typical HSES, both of whom were presented with nonketotic hypoglycaemia. In the first case, plasma insulin was 23 pmol/l at the time of hypoglycaemia (0.1 mmol/l). In the second case, increased values for interleukin-6 (IL-6) (319 pg/ml) and IL-8 (1382 pg/ml) were found 24 hours after admission, whereas IL-1 and tumour necrosis factor-alpha (TNF-alpha) were not measurable. Alpha-1-antitrypsin was decreased (0.6 g/l). In hyperpyrexic, unconscious and shocked infants, HSES should be considered and hypoglycaemia should be specifically looked for. Hypoglycaemia is not caused by hyperinsulinism but may be secondary to the release of cytokines.
Brain Diseases, Down Syndrome, Female, Humans, Hypoglycemia, Infant, Interleukin-6, Interleukin-8, Male, Shock, Hemorrhagic, Syndrome, Tomography, X-Ray Computed, Unconsciousness, alpha 1-Antitrypsin
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