Abstract
In the majority of patients who died with symptoms of status thymo-lymphaticus in the wards of the Babies'Hospital, the prostration of the patient was so marked that it was out of all proportion to the general physical findings. The clinical picture closely simulated a state of sugar shock from overdosage of insulin. It was, therefore, decided to determine the blood sugar level in such patients. In three cases where the diagnosis of status thymo-lymphaticus was confirmed by autopsy a sample of blood was taken within half an hour of death while the patient was in convulsions. The blood sugars were 52, 57, and 42 mg. per 100 cc. (Table I.) All three are considerably below the normal blood sugar of infants, which we have found to be between 80-120 mg. per 100 cc. as estimated by the Myers-Bailey modification of the Lewis Benedict method.
We have determined the blood sugar within half an hour of death in a series of patients with diseases other than status thymo-lymphaticus. (Table II.) The values are all normal or above normal. Hypoglycemia is not therefore a constant finding before death.
The blood sugars of six patients in convulsions of some hours'duration produced by conditions other than status thymo-lymphaticus were normal or above normal. (Table III.) It does not therefore seem probable that the convulsions alone produced the hypoglycemia.
The blood sugar was estimated in six cases of suspected status thymo-lymphaticus where roentgenograms showed a large thymus. The patients were not in convulsions at the time the sample of blood was taken. With the exception of one, which was slightly decreased, the Mood sugars were normal. (Table IV.)
The hypoglycemia, therefore, was temporary rather than continuous.
Acute suprarenal insufficiency is suggested as the immediate cause of the sudden death in status thymo-lymphaticus.
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