Hyperosmolar hyperglycaemic state (HHS) has not previously been reported in cystic fibrosis-related diabetes (CFRD). We report the case of a 15-year old boy with stable CFRD who developed acute HHS after treatment with glucocorticoids and itraconazole for presumed allergic broncho-pulmonary aspergillosis (ABPA). This case highlights the dangerous and preventable combination of high glucose intake, glucocorticoids and itraconazole inhibition of CYP3A4 (with resultant glucocorticoid accumulation) that can result in a state of life- threatening HHS in an adolescent with previously stable CFRD.

中文翻译：

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糖皮质激素与伊曲康唑相互作用引起的囊性纤维化相关糖尿病急性高渗性高血糖状态

高渗性高血糖状态 (HHS) 在囊性纤维化相关糖尿病 (CFRD) 中未见报道。我们报告了一名患有稳定型 CFRD 的 15 岁男孩，他在使用糖皮质激素和伊曲康唑治疗假定的过敏性支气管肺曲霉病 (ABPA) 后发展为急性 HHS。该病例突出了高葡萄糖摄入、糖皮质激素和伊曲康唑对 CYP3A4 的抑制（导致糖皮质激素蓄积）的危险和可预防的组合，这可能导致先前稳定 CFRD 的青少年处于危及生命的 HHS 状态。