Childhood Diseases

Posted by: Racoon | 2010/11/22


re: Concerned about 20 month old

Dear Doc

I wrote to you about a week ago re our 21 month old son who has a bloated belly, poor weight gain, cherubic features etc. You suspected endocrine problems. Well, visited our paed who sent him for sonar and xray for liver, spleen size and faecal loading, and results indicated a slightly enlarged liver and spleen with large faecal loading of the bowels. Blood tests indicated elevated Alk Phos (no other enzymes abnormal) and low ferritin. Tests for coeliac and dairy allergy negative. Our paed says alk phos due to bone growth. Started him on Pegicol for next 6 months, dewormed him and Chela-Fer supplement. I re-checked his growth/length since 12 months age and it went from above the 50th percentile to now at the 5th percentile (82 cm at 22 months). Our paed thinks his failure to thrive could be dietary due to the constipation. I told our paed we remained concerned and asked for endocrine tests. He agreed, although he thinks its unlikely. So, we will take the little guy for a pituitary screen tomorrow.

Your thoughts?

Expert's Reply



I am slightly happier but this is mainly due to your persistence in getting your paediatrician to do the proper tests.I am concerned that your son has an enlarged spleen and liver and very significant failure to thrive. Did you mention your concerns about his smaller than normal penis and also his undesecended testes?I continue to be concerned about his failure to thrive and am reluctant to blame this on constipation. In any case why is he so constipated?If a proper diagnosis is not obvious we may have to get a second opinion.

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user comments


Posted by: Purple | 2010/11/22

Thinking of you.

Reply to Purple

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