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{
    "pk": 596,
    "title": "Limb Ischemia in a Patient with Hyperosmolar Hyperglycemic State",
    "subtitle": null,
    "abstract": "A 61-year-old male with a recent diagnosis of pemphigus vulgaris was brought to the emergency department for altered mental status. He had recently started taking prednisone to manage his autoimmune disease and had a progressive decline in his mental status along with decreased oral intake. Evaluation revealed hyperosmolar hyperglycemic state (HHS) and occlusive arterial thrombosis, a rare but known complication of HHS. He was resuscitated aggressively with intravenous fluids, insulin, and heparin and admitted to the intensive care unit. Emergency physicians should remain vigilant for ischemic complications in patients with HHS. Early recognition and treatment can reduce the morbidity and mortality associated with this endocrine emergency.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [],
    "section": "Case Reports",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/7rs8z600",
    "frozenauthors": [
        {
            "first_name": "Ahmed",
            "middle_name": "",
            "last_name": "Al Hazmi",
            "name_suffix": "",
            "institution": "University of Maryland Medical Center, Department of Emergency Medicine, Baltimore, Maryland",
            "department": "None"
        },
        {
            "first_name": "Sara",
            "middle_name": "",
            "last_name": "Manning",
            "name_suffix": "",
            "institution": "University of Maryland Medical Center, Department of Emergency Medicine, Baltimore, Maryland",
            "department": "None"
        }
    ],
    "date_submitted": "2018-09-12T16:02:37-05:00",
    "date_accepted": "2018-09-12T16:02:37-05:00",
    "date_published": "2018-10-17T14:11:05-05:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "",
            "path": "https://journalpub.escholarship.org/uciem_cpcem/article/596/galley/357/download/"
        }
    ]
}