1 / 20

Palermo April 2014

Palermo April 2014. Virtut Velmishi. AMBRA 18 months. Brief story. First Child Normal pregnancy Birth weight = 3kg Exclusive breastfeeding for 6 months Complementary foods after this period Until 12 months everything ok. Problems. Chronic diarrhea Malnutrition

noma
Download Presentation

Palermo April 2014

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. PalermoApril 2014 VirtutVelmishi

  2. AMBRA18 months

  3. Brief story • First Child • Normal pregnancy • Birthweight= 3kg • Exclusive breastfeeding for 6 months • Complementaryfoodsafterthisperiod • Until 12 monthseverything ok

  4. Problems • Chronicdiarrhea • Malnutrition • Failure to thrive • 2 hospitalisations • Dermatitis ( treatedseveral times by dermatologist)

  5. Lab WBC=12000; RBC=5.080.000;HGB=7.7g/dl; PLT=358000 Urinary analisis = normal albuminemia=1,9 AST=123 U/L ALT=88 U/L IgA anti TTG> 100 UI /ml TotaleIgA =normal Weight=7,5 kg(-2,5DS) Height=79cm(-2DS)

  6. Hypoproteinemicedema

  7. dermatitisherpetiforme

  8. dermatitisherpetiforme

  9. Gluten free diet

  10. Fiqerete16 MONTHS OLD

  11. Brief story • First child • Birth weight =3400 g • Normal pregnancy, normal delivery • Exclusive breast fed first month • After she is fed by formula milk • 3 ½ month supplemental foods ( gluten also) • 2 hospitalizations: - 2 months : respiratory infection - 4 months : acute gastroenteritis • No familiary disease

  12. Four months ago( 12 month old)Chronic diarrheaFailure to thrive Vomiting

  13. Lab • WBC=12000; RBC=5.080.000;HGB=9.7g/dl; PLT=358000 • Urinary analisis = normal IgA anti DPG=107 u/ml Total IgA=normal TotaleIgA=108 u/ml

  14. Duodenal biopsy

  15. Biopsy Marsh 3 C

  16. Gluten free diet

  17. Growth chart

  18. But ....two weeks ago • Polyuria • Polydipsia • Glycaemia=459 mg/dl • Ketonuria= +++++ • Kussmal respiration • Ph=7.1; HCO3= 4.4 ; HbA1C = 7.4

  19. Second diagnosis • Diabetic ketoacidosis Coeliac disease association: T1DM

  20. ConclusionS • …some authors hypothized that in genetically susceptible patients one disease could predispose to another • … in patients with T1D, diabetes is usually diagnosed first, CD precedes diabetes onset only in 10-25%

More Related