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Sudden death in a patient newly diagnosed with diabetes having hyperosmolar non-ketotic acidosis with sickle cell trait
  1. O Biedrzycki1,
  2. H Gillespie2,
  3. S Lucas3
  1. 1St George’s Hospital, Tooting, London, UK
  2. 2Department for the Medicine of Ageing, Chelsea & Westminster Hospital, London
  3. 3Department of Histopathology, St Thomas’ Hospital, London
  1. Correspondence to:
 Dr O Biedrzycki
 St George’s Hospital, Tooting, London SW17, UK; olafbiedrzycki{at}aol.com

Abstract

Sickle cell trait (SCT) has a UK urban population rate estimated at 3.2%. The condition may remain unrecognised, but sudden death is a recognised feature. The sudden death of a 51-year-old man with SCT who presented with hyperosmolar non-ketotic acidosis (HONK) as his first presentation of diabetes is reported here. After admission to hospital, a rapid deterioration was seen in his condition, with loss of cardiac output, leading to death. He was found to have had acute-chest syndrome and hepatosplenic infarction on postmortem examination. The pathophysiology of sudden death in patients with SCT and the role of HONK in the patient’s demise is discussed here.

  • HONK, hyperosmolar non-ketotic acidosis
  • RBC, red blood cell
  • SCD, sickle cell disease
  • SCT, sickle cell trait

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Footnotes

  • Competing interests: None declared.