RESUMEN
Congenital sodium diarrhea is a rare cause of secretory diarrhea due to a defect in the sodium/proton exchanger that results in decreased sodium absorption and increased excretion in stools. We report a pre-term baby boy with a birth weight of 1.4 kg who was referred because of rapidly rising serum urea and creatinine. The initially reported high urine output was later found to be severe watery diarrhea with severe oliguria and acute renal failure. Associated findings were normal anion gap metabolic acidosis with hyponatremia that required > 50 mmol/kg of sodium per day for correction and about 300 ml/kg per day of replacement fluid to correct fluid and electrolyte abnormalities. The patient continues to do well 5 months after diagnosis.
Asunto(s)
Lesión Renal Aguda/etiología , Diarrea Infantil/congénito , Diarrea Infantil/complicaciones , Sodio/metabolismo , Diarrea Infantil/metabolismo , Humanos , Recién Nacido , MasculinoRESUMEN
OBJECTIVE: To examine the prevalence of celiac disease in young patients in the Kingdom of Saudi Arabia with type I diabetes mellitus. METHODS: Serum gliadin immunoglobulin (Ig) A and reticulin IgA antibody determination was performed in 123 patients with type I diabetes mellitus attending the pediatric diabetic clinic at King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia between 1995 and 1996. RESULTS: Elevated serum gliadin and reticulin IgA antibodies were found in the sera of 10 (8.1%) of the 123 diabetic children; none had gastrointestinal symptoms. Six of the 10 subjects had jejunal biopsy, which showed total villus atrophy. Four subjects did not undergo jejunal biopsy. The gender ratio of the biopsy positive is 5 male:1 female. All subjects with IgA positive were put on gluten free diet and normalized in a few months. CONCLUSION: The maximum prevalence of celiac disease in our population was 8.1% based on immunological marker and the minimum was 4.9% based on antibodies and biopsy results.
