The syndrome of marked hyperglycemia, coma, and death not associated with keto acidosis has received increasing recognition. Hyperosmolarity of the serum and severe dehydration are important features of this disorder. This report of three patients, two of whom survived, emphasizes the role of prior glucocorticoid therapy in precipitating the syndrome.
Boyer MH. Hyperosmolar Anacidotic Coma in Association With Glucocorticoid Therapy. JAMA. 1967;202(11):1007-1009. doi:10.1001/jama.1967.03130240049007