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INDEX OF SUSPICION

Eve R. Colson MD1
Neil Herendeen MD2
Peter Szilagyi MD, MPH2
William Bush MD3
Sharad Pandit MD4
 1 University of Connecticut School of Medicine, Farmington, CT
2 University of Rochester School of Medicine and Dentistry, Rochester, NY
3 DeVos Children's Hospital at Butterworth, Grand Rapids, MI
4 Cook County Hospital, Chicago, IL

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page.

We invite readers to contribute case presentations and discussions.

Case 1 Presentation

A 9-month-old African-American boy is brought to you in early April for a well child visit. Born after an uncomplicated pregnancy and delivery, he has been healthy at all previous visits and was noted to have normal growth and development when last seen at 6 months of age.

At this visit, the baby's length has dropped from the 50th to the 5th percentile, while his weight and head circumference remain at the 50th. He is breastfed and eats small amounts of chopped fruits and vegetables. His parents give him no foods that contain artificial ingredients, and he receives no supplemental vitamins. The baby's stools are normal in pattern and consistency, and he has had no recent illnesses.




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P. Weisberg, K. S Scanlon, R. Li, and M. E Cogswell
Nutritional rickets among children in the United States: review of cases reported between 1986 and 2003
Am. J. Clinical Nutrition, December 1, 2004; 80(6): 1697S - 1705S.
[Abstract] [Full Text] [PDF]


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