ISSN - 0973-0958

Pediatric Oncall Journal

https://www.pediatriconcall.com/Journal/images/journal_cover.jpg

Anemia, Rickets and Recurrent Diarrhea

Anemia, Rickets and Recurrent Diarrhea

22/07/2010 https://www.pediatriconcall.com/Journal/images/journal_cover.jpg
Dr Ira Shah.
Medical Sciences Department, Pediatric Oncall, Mumbai, India.

ADDRESS FOR CORRESPONDENCE
Dr Ira Shah, 1, B St Francis Road, Vile Parle {W}, Mumbai 400056. India.
Clinical Problem
A 2 and a half years old boy presented with abdominal distension and recurrent diarrhea for 6 months. Stools were frothy and had oil droplets. He also had a blood transfusion 2 month ago. At that time he had black coloured stools. There was no fever, bleeding from any site. Bone marrow examination at that time was normal. Doctor noticed bow legs at that time and gave 6 lakhs of Vitamin D. There was no jaundice, exposure to chronic drug abuse or altered sensorium. Diet was balanced mixed diet and immunization and milestones were normal. On examination, he was found to have palmar erythema, double malleoli, bow legs and hepatosplenomegaly with dilated tortuous abdominal veins with flow away from umbilicus. Other systems were normal.
 

With is the cause of his symptoms_?
 
Discussion
This child has organomegaly with palmar erythema suggestive of liver disease. He has dilated tortuous abdominal veins with flow away from umbilicus and splenomegaly suggestive of portal hypertension. Malena could be due to bleeding from varices. Malabsorption in form of frothy and oil droplets in stools suggests fat malabsorption which could be due to liver or pancreatic disease. Fat malabsorption leads to poor absorption of fat soluble vitamins such as Vitamin A, D, E and K. This could explain the rickets in the child. Anemia needing blood transfusion could be due to bleeding from varices or hypersplenism. Thus, the cause of problems in this child is chronic liver disease with portal hypertension even though child has never had jaundice.
 
Compliance with ethical standards
Funding:  None  
Conflict of Interest:  None
 
Cite this article as:
Shah I. Anemia, Rickets and Recurrent Diarrhea. Pediatr Oncall J. 2010;7: 92-93.
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
Disclaimer: The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0