Asunto(s)
Enfermedades Fetales/terapia , Hipoglucemia/terapia , Glucemia/análisis , Humanos , Recién NacidoRESUMEN
Hypothyroidism developed in a preterm infant, whose initial screening thyroid function test results were normal, at 2 weeks of life. The infant's mother was packing her Caesarian incision with iodine soaked gauze, resulting in a markedly increased breast milk iodine concentration. Treatment with oral L-thyroxine normalized thyroid function tests.
Asunto(s)
Lactancia Materna , Hipotiroidismo/inducido químicamente , Enfermedades del Prematuro/inducido químicamente , Yodo/efectos adversos , Administración Tópica , Femenino , Humanos , Recién Nacido , Yodo/administración & dosificación , Yodo/análisis , Leche Humana/química , MadresAsunto(s)
Transportadoras de Casetes de Unión a ATP/genética , Hiperinsulinismo Congénito/genética , Hipoglucemia/etiología , Canales de Potasio de Rectificación Interna/genética , Canales de Potasio/genética , Proteínas/efectos adversos , Receptores de Droga/genética , 3-Hidroxiacil-CoA Deshidrogenasas/genética , Transportadoras de Casetes de Unión a ATP/metabolismo , Adenosina Trifosfato/metabolismo , Niño , Humanos , Hipoglucemia/metabolismo , Lactante , Mutación , Canales de Potasio/metabolismo , Canales de Potasio de Rectificación Interna/metabolismo , Receptores de Droga/metabolismo , Receptores de SulfonilureasRESUMEN
OBJECTIVE: To characterize the prodrome, presentation, family history, and biochemical status at diagnosis of type 1 diabetes mellitus (T1D) in children under age 6 years. STUDY DESIGN: This was a retrospective chart review of patients hospitalized at diagnosis with T1D from 1990 to 1999 in a children's hospital. RESULTS: A total of 247 children were hospitalized, 44% of whom presented in diabetic ketoacidosis (DKA). When stratified by 2-year age intervals, only total carbon dioxide (tCO(2)) was significantly lower in the youngest children (P = .02), and the duration of candidiasis was significantly longer in those children presenting in DKA (P = .004). Parents were more likely to recognize symptomatic hyperglycemia in children older than 2 years (P < .0001). Most parents sought care for their child suspecting that the child had diabetes; the other children were diagnosed when presenting with another concern. Only gender and tCO(2) were significantly correlated with hemoglobin A1c (HbA1c); age-adjusted HbA1c was 0.64% higher in girls compared with boys (P = .045), and each 1-mmol/L decrement in tCO(2) increased the age- and gender-adjusted HbA1c by 0.086% (P < .001). CONCLUSIONS: A high proportion of children under age 6 years present critically ill at the diagnosis of T1D. When any of the classic symptoms of diabetes or a yeast infection is present, a serum glucose level should be measured.
Asunto(s)
Diabetes Mellitus Tipo 1/diagnóstico , Glucemia/análisis , Boston/epidemiología , Candidiasis/epidemiología , Dióxido de Carbono/sangre , Niño , Preescolar , Diabetes Mellitus Tipo 1/epidemiología , Cetoacidosis Diabética/epidemiología , Femenino , Hemoglobina Glucada/análisis , Humanos , Masculino , Análisis Multivariante , Padres , Aceptación de la Atención de Salud , Atención Primaria de Salud , Estudios Retrospectivos , Factores SexualesRESUMEN
Although glycogen storage disease type 0 (GSD0) is included in the differential diagnosis of ketotic hypoglycemia, it usually is not considered in the evaluation of glucosuria or hyperglycemia. We describe two children with GSD0, confirmed by mutation analysis, who had glucosuria and hyperglycemia. Because of the variable presentation of this disorder and previous dependence on liver biopsy to confirm diagnosis, it is likely that GSD0 is underdiagnosed.