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June 4, 2004

Diagnosis and Symptoms, Other Illnesses

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Question from Tucson, Arizona USA:

My daughter is four years old. She has recurrent fever episodes and respiratory problems. When she is not sick, you would never know she gets so sick. She is very bright and very healthy otherwise. She has these problems monthly. She is now on medications to control them, but before the medications and now, while on them, when she is sick, her glucose is high in her blood and urine.

During an episode of severe diarrhea caused by Bactrim, she was hospitalized. I just got her records and they again show high glucose levels. Urine levels were over 1000 and blood was 149 mg/dl [8.3 mmol/L]. I have seen results for blood go upwards from the 180s mg/dl [10.0 mmol/L]. She see’s an immunologist, a pulmonologist, a hematologist, a pediatrician, and an infectious disease specialist. We have been to the Emergency Room on multiple occasions because of her respiratory problems. Her doctors have never mentioned the blood glucose issue. Her next appointment is coming up in another month. I will bring it up then. I know you can’t diagnose her, but is it her illness’ raising her blood glucose or is it a very strong case for diabetes??

I have been told my daughter has PFAPA (Periodic Fever, Aphthous stomatitis, Pharyngitis, and cervical Adenitis) Cyclic Neutropenia, and various other things that every other doctor disagrees with and all keep getting ruled out. NO ONE seems to know what is wrong with my little girl. Her blood work shows a possible immunological deficiency and she has not developed antibodies to certain immunizations. Again, I am not looking for a diagnosis. I just want to know if she could have diabetes so I can get her to the right kind of doctor.

Answer:

From: DTeam Staff

You, of course, recognize the difficulty of offering an online opinion about your daughter. She needs the expertise of an experienced pediatrician to help you sort through and follow-up on her various problems. With that said, it seems possible that this may also be early diabetes and will require further testing in the future and close observation for development of diabetes. I would review your concerns with your pediatrician at length until all of your questions are addressed to your satisfaction.

MSB