RESUMO
An 8-month-old male infant patient was referred to our institution (from elsewhere) with a history of fever, convulsions, dystonic posturing, altered sensorium, and loss of motor and mental milestones since past 1 month. Upon admission to our institution, a neuroimaging (magnetic resonance imaging of the brain) revealed frontoparietal atrophy, "bat-wing appearance," and basal ganglia changes. Carnitine and acylcarnitine profile revealed low total carnitine, very low free carnitine, and low free/acylcarnitine ratio, with normal levels of plasma amino acids. Urine gas chromatography mass spectrometry showed an elevated level of ketones (3-hydroxybutyric acid and acetoacetate) and glutaric acid with the presence of 3-hydroxyglutaric acid, suggestive of glutaric aciduria type 1. Diet modification and pharmacotherapy with riboflavin and carnitine arrested the neurological deterioration in the patient.
RESUMO
A 6-year-old male child patient was brought to the emergency pediatric room with alleged history of accidental ingestion of approximately 15 mL kerosene oil. The child developed vomiting shortly after the consumption. Chest radiograph taken 6 hours after ingestion did not show any abnormalities. On the second day of hospital stay, the patient started complaining of severe abdominal pain. His serum amylase and lipase levels were elevated significantly, suggesting the development of acute pancreatitis. He was investigated for the other possible causes of acute pancreatitis, which were normal. There is paucity of literature regarding occurrence of acute pancreatitis following kerosene poisoning, both in children, as well as adults, because of its rarity. A high index of suspicion should be kept in mind and a differential diagnosis of acute pancreatitis should be considered in cases of acute kerosene poisoning, who complain of pain in abdomen.