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from emedicine; Image Case 21   Message List  
Reply | Forward Message #213 of 1276 |


Note: forwarded message attached.


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Dr Santosh Kondekar, MD DCH FCPS
from:Seth GS Medical college & KEM Hospital Mumbai, India
http://kempeds.learn.to


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Wed Apr 23, 2003 7:51 am

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eMedicine Case
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Hypoglycemia in Childhood  



Normal growth may be within their reach. One in every 33 babies born in the US each year is considered low birth weight and/or length. Low birth weight and/or height is a result of babies born small for gestational age (SGA). Growth failure in children due to SGA who have not attained catch-up growth by age 2 may be candidates for exogenous GH. Other causes of short stature in children should be excluded.

 

BACKGROUND
A 14-month-old girl is referred to a pediatric endocrinologist after she had 5 episodes of staring, limpness, and unresponsiveness beginning at 10 months of age. The episodes lasted 5-30 minutes. The first episode occurred when the child was hospitalized for a rotaviral infection. The other 4 occurred after several hours of fasting, though she was otherwise healthy. The child's blood glucose levels were measured during 2 of the episodes and found to be 43 and 47 mg/dL. A neurologist evaluated the girl and obtained an EEG, a head MRI, a serum ammonia measurement, a lactic acid concentration, an acyl carnitine profile, qualitative amino acid levels, and urine metabolic values. The results were all normal.

The child's past medical history is otherwise unremarkable. She was born at term with a weight of 3.5 kg and length of 50 cm (both in the 50th percentile). Her only surgery was for the placement of tympanostomy tubes to treat recurrent otitis media. She began crawling at 9 months and walking at 14 months.

The physical examination reveals a proportionate girl with a weight of 8.5 kg (10th percentile) and a length of 68.5 cm (mal results: morning cortisol level, insulin level, thyroxine (T4) level, thyroid-stimulating hormone (TSH) level, and oral glucose tolerance test. Her insulinlike growth factor-1 (IGF-1) level is undetectable.
Hint
Growth delay
Author: Pamela A Clark, MD

Head, Section of Pediatric Endocrinology, Associate Professor, Department of Pediatrics, University of Louisville
 



 
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Wed Apr 23, 2003 7:10 am

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Forward 		Message #213 of 1276 |
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Note: forwarded message attached. ******************************************************************************************** Dr Santosh Kondekar, MD DCH FCPS... 		Pediatrician santosh ...
drkondekar@...
Send Email 		Apr 23, 2003
7:51 am
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