OBJECTIVE: This report describes a new fatal syndrome observed in adolescent males at the initial presentation of @entity6 . The features include @entity772 complicated by a @entity590 with @entity221 , @entity5925 , and severe @entity65 . DESIGN: Case series. SETTING: Pediatric intensive care units of 3 tertiary care facilities in the United States. @entity1 : Six adolescent males, 5/6 obese with acanthosis nigricans, 4/6 black. RESULTS: Four of 6 @entity1 died. Four of 6 @entity1 did not have significant @entity1270 . Six of 6 @entity1 had increased temperature after the administration of insulin. CONCLUSIONS: The underlying etiology of this syndrome remains unclear. Possibilities include an underlying @entity209 such as a @entity844 oxidation defect, an unrecognized infection, exposure to an unknown toxin, or a genetic predisposition to @entity590 . Evaluation for all these possibilities and empiric treatment with @entity592 should be considered for this type of @entity1 until this syndrome is better characterized.

Fatal @entity590 with @entity5925 complicating the presentation of XXXX in adolescent males.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'PATIENTS'] @entity844 :: ('CHEBI:35366', 'Chemical') :: ['fatty acid'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes mellitus'] @entity772 :: ('MESH:D003128', 'Disease') :: ['hyperglycemic hyperosmolar coma'] @entity5925 :: ('MESH:D012206', 'Disease') :: ['rhabdomyolysis'] @entity590 :: ('MESH:D008305', 'Disease') :: ['malignant hyperthermia-like picture', 'malignant hyperthermia'] @entity1270 :: ('MESH:D007662', 'Disease') :: ['ketosis'] @entity209 :: ('MESH:D008659', 'Disease') :: ['metabolic disorder'] @entity592 :: ('MESH:D003620', 'Chemical') :: ['dantrolene'] @entity221 :: ('MESH:D005334', 'Disease') :: ['fever'] @entity65 :: ('MESH:D002318', 'Disease') :: ['cardiovascular instability']
@entity6 :: (MESH:D003920,Disease) :: ['diabetes mellitus']
