Metabolic acidosis as Food Protein Induced Enterocolitis Syndrome (FPIES) onset in a newborn.

BACKGROUND: FPIES (Food Protein Induced Eneterolitis Syndrome) is a rare non IgE- mediated food allergy, usually affecting infants and children after first months of life. Clinical presentation is heterogeneous, usually characterised by repetitive vomiting and diarrhoea, lethargy, failure to thrive until to dehydration with hypotension and shock. The diagnosis is based on clinical criteria, after excludind other hypothetical conditions. Early recognition of FPIES is essential to set a correct dietatay management that is resolving for the patient. CASE REPORT: We present the case of a 12 days old child who was admitted to the hospital for poor feeding, failure to thrive and severe metabolic acidosis. CONCLUSIONS: The early onset of this case is peculiar and rember us to consider FPIES in differential diagnosis of newborn metabolica acidosis.

Endocrine and growth features in childhood craniopharyngioma: a mono-institutional study.

OBJECTIVE: To evaluate growth and endocrine features in children with craniopharyngioma who were treated and followed up by a single institution between 1976 and 2004. PATIENTS: The records of 32 children, 18 males and 14 females, were evaluated. The mean follow-up period was 6.3 years. RESULTS: At presentation, the most common symptoms were headache, nausea and vomiting, visual impairment, and neurological changes. Some patients presented signs or symptoms of isolated or combined endocrine disorder (five polyuria and polydipsia, five growth failure, two precocious puberty, eight obesity or overweight). After tumour treatment, multiple pituitary hormonal deficiencies, especially growth hormone (GH) deficit (GHD) were found and required hormonal replacement therapy. Eight children grew normally without GH despite GHD. Hypothalamic involvement was observed in ten patients; obesity was frequent and was often associated with hyperinsulinism and hyperphagia. CONCLUSION: Anterior and posterior pituitary deficiencies following surgery are present in all patients. The growth pattern is heterogeneous.