Diagnostic Dilemma


A 10 years girl presented with increased frequency of urine {gets up 6-8 times in night and polyuria}, ants on voided urine and warm body for 2months. There is contact with patient of tuberculosis. On examination, blood pressure is 100 -70 mm of Hg, has mild pedal edema, mild ascitis and prominence of superficial veins over abdomen. Other systems are normal. On investigation, urine pH is 7.0 and specific gravity is 1010 with sugar 2 percent and no proteins. Her Glucose Tolerance Test is Table 1. Her renal function tests, Albumin and thyroid function tests are normal. Ultrasound abdomen shows large dilated gut suggestive of megacolon. Her blood gases show pH of 7.32 and bicarbonate of 21.3 mmol , l and Base excess of -3.6 mmol, L.

How to proceed further_?
Answer Discussion :
Ganga Chandramohan
Polyuria with abnormal GTT, mild metabolic acidosis, glycosuria and megacolon. Appears to be patient has uncontrolled Type I diabetes. May initiate diet and insulin treatment and check labs again.
14 years ago
T Jothicash
juvenile diabetes with tuberculosis abdomen
14 years ago

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