Blood and Guts: A Case of Early Childhood Crohn’s Disease
| العنوان: | Blood and Guts: A Case of Early Childhood Crohn’s Disease |
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| المؤلفون: | Kevin Chang, Arathi Lakhole, Cindy Le Sessions, Nick Shillingford, Ronald M. Ferdman |
| المصدر: | Hospital Pediatrics. 6:248-251 |
| بيانات النشر: | American Academy of Pediatrics (AAP), 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Diarrhea, Male, Parenteral Nutrition, medicine.medical_specialty, Pathology, Anemia, Biopsy, Anti-Inflammatory Agents, Aspartate transaminase, Pediatrics, Gastroenterology, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, 030225 pediatrics, Internal medicine, medicine, Humans, Hypoalbuminemia, Mesalamine, Glucocorticoids, Mean corpuscular volume, Enterocolitis, Crohn's disease, medicine.diagnostic_test, biology, business.industry, Disease Management, Colonoscopy, General Medicine, medicine.disease, Alanine transaminase, Child, Preschool, Pediatrics, Perinatology and Child Health, biology.protein, 030211 gastroenterology & hepatology, medicine.symptom, business |
| الوصف: | A 3-year-old Latino boy was transferred to a tertiary children’s hospital after presenting with poor oral intake, several days of nonbloody/nonbilious emesis, and blood-streaked diarrhea. He was afebrile with normal vital signs; height was at the 15th percentile and weight at the sixth percentile; and BMI was 14.5 at the eighth percentile. He was a tired-appearing and pale toddler who was crying but consolable. He had dry lips with hyperactive bowel sounds but with a nontender and nondistended abdomen. He had bilateral pitting edema to his ankles and periorbital edema. He was previously diagnosed as an outpatient with iron-deficiency anemia. His bloody diarrhea was thought to be secondary to milk-protein enterocolitis due to both its onset being around the time his diet was diversified between 6 and 12 months of age and to the finding of hypoalbuminemia. He was on an elimination diet of milk products plus supplementation with an extensively hydrolyzed whey protein formula. He had an esophagogastroduodenoscopy and colonoscopy done 6 weeks before this hospitalization demonstrating friable, edematous, and nodular colonic mucosa, with no duodenal villi blunting or colonic cryptitis, granulomas, or dysplasia on biopsy. These results were inconclusive but suggested a degree of inflammation. Laboratory tests showed a white blood cell count of 25 000 cells/μL with 31% bands and a hemoglobin of 9.9 g/dL with a mean corpuscular volume of 77 fL. His sodium was 127 mEq/L, potassium of 2.1 mEq/L, albumin of 2.7 g/dL, total protein of 5.3 g/dL, aspartate transaminase of 22 U/L, alanine transaminase of 20 U/L, total bilirubin of 0.4 mg/dL, and C-reactive protein of 4.9 mg/dL. Infectious stool studies sent on admission were negative, including norovirus and adenovirus polymerase chain reaction, routine culture and stain for ova and parasite, rotavirus DAA, and Clostridium difficile molecular assay. His diet was changed to an … |
| تدمد: | 2154-1671 2154-1663 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::84f175127875e900e7a67e6d805ddb44Test https://doi.org/10.1542/hpeds.2015-0057Test |
| رقم الانضمام: | edsair.doi.dedup.....84f175127875e900e7a67e6d805ddb44 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 21541671 21541663 |
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