A 6 y/o female is seen by her pediatrician because her mother became concerned w

Question

A 6 y/o female is seen by her pediatrician because her mother became concerned with her small stature and low weight. The physician notes that she is in the 18th percentile in height and 23rd percentile in weight. The mother states that the Px is thirsty ‘all the time’ and urinates constantly. Blood and urine tests show that the Px has hypokalemia, proteinuria, hypophosphatemia, glycosuria, and a blood HCO3 level of 14 mEq/L.   A bone density scan indicates that the Px has osteomalacia. Neither parent has any genetic concerns. When the physician inquired about the child’s eating habits and environment, the mother states that she has a normal diet that includes all the food groups, but she always puts things in her mouth. The family lives in a section of the city that was built in the 1930’s.

Is this a congenital or acquired disease based on the data? Explain the logic.

Explanation / Answer

SYMPTOMS

Small stature, low weight, increased thirst, polyuria

BIOCHEMICAL TESTS

Proteinuria, glucosuria, low HCO3.

RADIOLOGICAL TESTS

Osteomalacia

1. All the above facts point towards the diagnosis of JUVENILE/ TYPE 1 diabetes mellitus in this child.

2. None of the parents had any genetic concerns.Furthermore type 1 diabetes is ACQUIRED due to destruction of beta cells of pancreas that produce insulin.

3. This destruction of beta cells can be triggered by VIRAL INFECTIONS like flu or due to CHEMICALS in the environment.

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