Abstract: Objective: To analyze the clinical diagnosis and treatment of the patient with brain edema, acute myocardial injury, acute liver injury, rhabdomyolysis and other complications caused by diabetic ketoacidosis(DKA) combined with hyperglycemic hyperosmolar state(HHS), and to improve the clinicians' understanding of the multiple organ dysfunction syndrome caused by DKA combined with HHS. Methods: The clinical materials of a patient with DKA combined with HHS were collected, and the relevant literatures were reviewed; the diagnosis and treatment methods of the disease were analyzed. Results: A female 26-year-old patient was admitted to hospital because of "poor appetite, palpitation for 1 month, nausea and vomiting for 3 d, aggravation with unconsciousness for 3 h". The main clinical manifestations of the patient were shock,HHS,ketoacidosis,brain edema, acute myocardial injury, acute kidney injury, rhabdomyolysis and so on;the diagnosis was DKA complicated HHS and MODS.The patient was treated with fluid resuscitation, insulin, blood purification,organ protection. After that, the patient's vital signs were stable and the organ functions were improved,the patient was discharged. The telephone follow-up 6 months after discharge showed that blood glucose and organ function were normal. Conclusion: DKA complicated with HHS is vital sign of poor prognosis, especially in the younger patients. In case of MODS, early diagnosis and prevention is the key to reduce death and improve prognosis.

Key words: diabetes mellitus, diabetic ketoacidosis, hyperglycemic hyperosmolar state, rhabdomyolysis, acute kidney injury