| Abstrakt: |
Case 1: A 14-year old girl child presented with complaints of tiredness, dehydration, amenorrhea since puberty, mental retardation, absence of fifth metacarpal. The RBS was found to be 246 mg/dL. Urinary Ketones, Serum ketones, anion gap, bicarbonate and pH of blood were all indicative of DKA. USG abdomen revealed chronic calcific pancreatitis. Necessary IV fluids were initiated and insulin therapy was provided. Case 2: A 11-year old boy presented with complaints of polyuria, polydipsia, polyphagia, abdominal pain, weight loss, difficulty in eating and increase bowel movements. The RBS was found to be 622mg/ dL. Urinary Ketones, Serum ketones, anion gap, bicarbonate and pH of blood were all in the normal range. Thus indicative of Hyperglycemic Hyperosmolar Syndrome. USG abdomen and MRI revealed dilated duct showing calcific pancreatitis. Necessary IV fluids were initiated and insulin therapy was provided. Comparison Study: Both cases had calcific pancreatitis, consanguinity, poor diabetic control in common. What was unusual between them was, one presented with DKA and other had No DKA. Mental retardation, facial features, absent metacarpal and amenorrhea were presented only in case 1, thus the associated syndromes must be taken into account. Conclusion: The clinical presentation of fibrocalcific pancreatitis is rare in children and associated with the SPINK 1 gene. Conservative glycemic control, frequent blood glucose monitoring and correction of the micro and macronutrient deficiencies are very fundamental in the management of patients with FPD and should be strongly emphasized. Treatment responses will be variable in both cases and the other associated conditions of hormonal abnormalities need to be corrected for better quality of life for the children. Such cases of calcific pancreatitis in children are rare and should be thoroughly investigated. [ABSTRACT FROM AUTHOR] |
