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Unresolving short stature in a possible case of mucopolysccharidosis
Ac Ayuk1, Ho Obu1, Md Ughasoro1
1Department of Pediatrics, University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria.
Insights
This case highlights a rare metabolic disorder, mucopolysaccharidoses, presenting as short stature and skeletal deformities. Early diagnosis is crucial for children with unexplained growth issues and developmental delays.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Genetics
Background:
- Rickets treatment can mask underlying rare metabolic disorders.
- Short stature and skeletal deformities require comprehensive differential diagnosis.
Observation:
- A 4-year-old male presented with persistent short stature, skeletal deformities, and developmental delays after rickets treatment.
- Clinical examination revealed dysmorphic features including coarse facies, large head, and corneal clouding.
Findings:
- Diagnosis of Hurler syndrome (mucopolysaccharidosis type I) was established based on clinical and radiological findings.
- The patient exhibited severe growth failure and significant developmental delays.
Implications:
- Emphasizes the importance of considering rare metabolic conditions like mucopolysaccharidoses in pediatric patients with unexplained symptoms.
- Highlights the need for early and accurate diagnosis to guide appropriate management and genetic counseling.
Abstract:
We present a metabolic disorder with main complaints of unresolving short stature following prolonged treatment for rickets. ES is a 4-year-old male who first presented to our hospital on self-referral but had been seen previously at another tertiary health facility. The complaints were a swelling on the back and poor growth since 1 year of age with associated skeletal deformities: Chest wall, wrists, knees and ankle joints, which were progressive. Examination revealed a severely stunted child with a large head and caput quadratum, craniofacial disproportion, coarse facial features, saddle-shaped nose, thick lips and bilateral corneal clouding/opacities. He had very poor language development for his age. His diagnoses based on clinical and radiological assessment was in keeping with Hurlers type of mucopolysaccharidoses. We highlight this case to emphasize the need for early consideration of other possible rare differential diagnoses in metabolic conditions in children.
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