Differentiating Cretinism from other diseases: Difference between revisions
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==Differentiating X from other Diseases== | ==Differentiating X from other Diseases== | ||
Cretinism must be differentiated from other diseases that cause a failure to pass [[meconium]] or [[abdominal distension]] in infants, including [[meconium plug syndrome]], [[small left colon syndrome]], and [[Hirschsprung's disease]]. | |||
* | {| class="wikitable" | ||
!Disease | |||
!Prominent clinical features | |||
!Radiological findings | |||
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|[[Meconium plug syndrome]] | |||
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* Transient [[intestinal obstruction]] for 1-2 days after birth. | |||
* Obstruction is functional due to dilated colon and delayed passage of feces. | |||
* Usually seen in [[premature infants]].<ref name="pmid18485962">{{cite journal |vauthors=Keckler SJ, St Peter SD, Spilde TL, Tsao K, Ostlie DJ, Holcomb GW, Snyder CL |title=Current significance of meconium plug syndrome |journal=J. Pediatr. Surg. |volume=43 |issue=5 |pages=896–8 |year=2008 |pmid=18485962 |pmc=3086204 |doi=10.1016/j.jpedsurg.2007.12.035 |url=}}</ref> | |||
|[[Image:Meconium-plug-syndrome - Case courtesy of Radswiki, Radiopaedia.org, rID 11606.jpg|center|300px|thumb|Abdominal x-ray with contrast showing inspissated meconium in the intestine, proximal to the colon - Case courtesy of Radswiki, Radiopaedia.org, rID 11606]] | |||
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| | |[[Small left colon syndrome]] | ||
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* Reduced caliber of the [[colon]] starting from [[splenic flexure]] and going down, causing [[intestinal obstruction]]. | |||
* Characterized by a sudden change of the colon diameter. | |||
| | * Usually associated with [[gestational diabetes]].<ref name="pmid910057">{{cite journal |vauthors=Berdon WE, Slovis TL, Campbell JB, Baker DH, Haller JO |title=Neonatal small left colon syndrome: its relationship with aganglionosis and meconium plug syndrome |journal=Radiology |volume=125 |issue=2 |pages=457–62 |year=1977 |pmid=910057 |doi=10.1148/125.2.457 |url=}}</ref> | ||
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| | |[[Image:Small-left-colon-syndrome-1 - Case courtesy of Dr Eric F Greif, Radiopaedia.org, rID 30024.jpg|center|300px|thumb|Abdominal x-ray with contrast, shows decreased caliber of the descending and sigmoid colon, loss of haustration along with filling defects corresponding to retained feces - Case courtesy of Dr Eric F Greif, Radiopaedia.org, rID 30024]] | ||
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| | |[[Intestinal atresia|Distal small intestine/colon atresia]] | ||
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* Failure to pass [[meconium]] due to failure of intestine recanalization. | |||
| | * Proximal [[lesions]] have an earlier onset of symptoms than distal [[lesions]]. | ||
| | * [[Intestinal atresia|Colonic atresia]] may affect normal children or may be associated with other abnormalities as Hirschsprung's disease or [[gastroschisis]].<ref name="pmid17077911">{{cite journal |vauthors=Spitz L |title=Observations on the origin of congenital intestinal atresia |journal=S. Afr. Med. J. |volume=96 |issue=9 Pt 2 |pages=864 |year=2006 |pmid=17077911 |doi= |url=}}</ref> | ||
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| | |[[Image:Small-bowel-atresia - Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID 5959.jpg|center|300px|thumb|Normal appearing colon that is small and unused. Contrast fills the whole colon and passes to the ileum - Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID 5959]] | ||
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| | |[[Meconium ileus]] | ||
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| | * [[Intestinal obstruction]] due to inspissation of [[meconium]] in the [[Ileum|distal ileum]]. | ||
| | * Most cases of [[meconium ileus]] are secondary to [[cystic fibrosis]]. | ||
| | * Typically presents with failure to pass [[meconium]] and [[abdominal distension]] with or without [[vomiting]]. | ||
| | * [[Meconium ileus]] may first present with complications, including [[perforation]] and [[volvulus]].<ref name="pmid14237408">{{cite journal |vauthors=HOLSCLAW DS, ECKSTEIN HB, NIXON HH |title=MECONIUM ILEUS. A 20-YEAR REVIEW OF 109 CASES |journal=Am. J. Dis. Child. |volume=109 |issue= |pages=101–13 |year=1965 |pmid=14237408 |doi= |url=}}</ref> | ||
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| | |[[Image:Meconium-ileus-neonate-with-cystic-fibrosis - Case courtesy of Dr Michael Sargent, Radiopaedia.org, rID 6009.jpg|center|300px|thumb|Contrast enema shows inspissated meconium starting from the mid-sigmoid colon and going up till the splenic flexure. The colon is normal in diameter, ruling out microcolon - Case courtesy of Dr Michael Sargent, Radiopaedia.org, rID 6009]] | ||
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| | |[[Congenital hypothyroidism]] | ||
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*Most infants are born [[asymptomatic]].<ref name="pmid2295961">{{cite journal |vauthors= |title=Elementary school performance of children with congenital hypothyroidism. New England Congenital Hypothyroidism Collaborative |journal=J. Pediatr. |volume=116 |issue=1 |pages=27–32 |year=1990 |pmid=2295961 |doi= |url=}}</ref> | |||
*Symptoms, if present, may include, but not limited to: | |||
| | **[[Macroglossia]] | ||
| | **Hoarse cry | ||
| | **[[Umbilical hernia]] | ||
| | **Puffy facies | ||
**Increased head circumference | |||
| | **[[Hypothermia]] | ||
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== | ==References== | ||
{ | {{reflist|2}} | ||
[[Category:Endocrinology]] | |||
[[Category:Disease]] | |||
{{WS}} | |||
{{WH}} | |||
==References== | ==References== | ||
Revision as of 19:01, 6 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
OR
[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
Differentiating X from other Diseases
Cretinism must be differentiated from other diseases that cause a failure to pass meconium or abdominal distension in infants, including meconium plug syndrome, small left colon syndrome, and Hirschsprung's disease.
| Disease | Prominent clinical features | Radiological findings |
|---|---|---|
| Meconium plug syndrome |
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| Small left colon syndrome |
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| Distal small intestine/colon atresia |
|
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| Meconium ileus |
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| Congenital hypothyroidism |
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References
- ↑ Keckler SJ, St Peter SD, Spilde TL, Tsao K, Ostlie DJ, Holcomb GW, Snyder CL (2008). "Current significance of meconium plug syndrome". J. Pediatr. Surg. 43 (5): 896–8. doi:10.1016/j.jpedsurg.2007.12.035. PMC 3086204. PMID 18485962.
- ↑ Berdon WE, Slovis TL, Campbell JB, Baker DH, Haller JO (1977). "Neonatal small left colon syndrome: its relationship with aganglionosis and meconium plug syndrome". Radiology. 125 (2): 457–62. doi:10.1148/125.2.457. PMID 910057.
- ↑ Spitz L (2006). "Observations on the origin of congenital intestinal atresia". S. Afr. Med. J. 96 (9 Pt 2): 864. PMID 17077911.
- ↑ HOLSCLAW DS, ECKSTEIN HB, NIXON HH (1965). "MECONIUM ILEUS. A 20-YEAR REVIEW OF 109 CASES". Am. J. Dis. Child. 109: 101–13. PMID 14237408.
- ↑ "Elementary school performance of children with congenital hypothyroidism. New England Congenital Hypothyroidism Collaborative". J. Pediatr. 116 (1): 27–32. 1990. PMID 2295961.