April- 2005 Newsletter - Pediatric Oncall

DIAGNOSTIC DILEMMA:
This month’s diagnostic dilemma: A twin has gross hypotonia and edema at birth with cortical atrophy and nephrocalcinosis…What is the differential diagnosis? Read the complete case and answer the dilemma…

http://www.pediatriconcall.com/fordoctor/diagnosisdilemma/listdilemma.asp

Last month’s query of a 6½ years old boy with hepatosplenomegaly, intermittent anemia, intermittent jaundice and negative hemolytic anemia work up had lot of answers. Most viewers have suggested Wilson’s disease, hereditary spherocytosis, G-6-PD deficiency, Kala azar etc. The authors have replied that his Wilson's workup was negative. Liver biopsy was inconclusive. His bone marrow and liver biopsy did not show any evidence of LD bodies ruling out KALA AZAR. Barium meal follow through also is normal. They will repeat his G-6-PD after 3 months to see if he is deficient.

http://www.pediatriconcall.com/fordoctor/diagnosisdilemma/listdilemma.asp

TEACHING FILES:
This month’s teaching File:
A six-month-old presents with severe metabolic acidosis, polyuria and polydipsia with neuroregression. What is the diagnosis? Read the entire teaching clinical query in the section of “TEACHING FILES” and try the correct answer.

http://www.pediatriconcall.com/fordoctor/teaching/clinical_propblem_list.asp

Last month’s teaching file:
Query: A 4½ years old boy presents with recurrent glossitis with neutropenia at the time of tongue lesions. What is the diagnosis?
Answer: The diagnosis “Cyclic Neutropenia”. ". This child has a cyclical course of his symptoms with tongue lesions coming every 20 days. Similarly, if one looks carefully at his hemogram, one can see neutropenia, which has a cyclical course as the symptoms. Discuss this case further in the section of “DISCUSSION GROUPS”. A 7 years old boy presents with recurrent hypocalcemic convulsions and fever. On examination, he has generalized lymphadenopathy. Investigations reveal neutrophilia with thrombocytosis, normal PTH levels and low immunoglobulins. What is the diagnosis?

PRACTICAL GUIDELINES:
TYPHOID FEVER:
Dr Vishal Dublish, Dr Ira Shah Read recent advances in typhoid including newer laboratory diagnostic methods and management of enteric fever.

http://www.pediatriconcall.com/fordoctor/diseasesandcondition/typhoid_fever.asp

ANESTHESIA FOR PEDIATRIC LAPROSCOPY:
Dr Sunita Goel, Consultant Anesthesiologist, Mumbai The chief difference in anesthetic management between Laproscopy and other abdominal procedures in children relates to the cardiorespiratory resulting from pneumoperitoneum and positioning. Read more…

http://www.pediatriconcall.com/fordoctor/diseasesandcondition/anesthesia_laproscopy.asp

CASE REPORTS:
EPIDERMAL NEVI SYNDROME - A CASE REPORT:
Neeraj - Awasthy, Premila Pul, Safdarjung Hospital, Delhi This is an interesting case of a four-year-old girl with seizures and nevus on the left cheek. Read more…

http://www.pediatriconcall.com/fordoctor/casereports/epidermal_nevi_syndrome.asp

GRAVE’S DISEASE: Read about a 4 year old girl who presented with just sinus tachycardia. Investigations revealed hyperthyroidism. Read more…

http://www.pediatriconcall.com/fordoctor/casereports/graves.asp


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