Consultant for Pediatricians Vol 8 No 9

A 16-year-old boy with Down syndrome was referred for evaluation of nonspecific symptoms, including difficulty in breathing on standing up from a sitting position, dizziness, frequent abdominal pain, and diarrhea after ingesting fatty foods and milk. He had intermittent asthma exacerbations for which he occasionally used a β-agonist. He had no history of trauma, surgery, or allergies.

In early summer, an 8-year-old boy from rural central Virginia was brought for evaluation of a rash on his buttock. He had noticed the rash that morning, when it became pruritic. The father had removed a tick from the area about 10 days earlier. The child denied fever, headache, vomiting, fatigue, arthralgia, myalgia, and other symptoms.

When reaching under a shed for the frog she had been chasing, a 4-year-old girl was bitten by “something.” The parents thought the bite was from a snake because of reports of copperhead sightings in the area. The mother immediately brought the child to the emergency department (ED).

The American Academy of Pediatrics (AAP) recently doubled the amount of vitamin D that it recommends all infants, children, and adolescents receive each day-from 200 to 400 IU. Also new is the academy's recommendation that vitamin D supplementation begin as soon after birth as possible. Supplementation is recommended in infants who do not receive 400 IU per day from formula.

An 18-year-old girl presented for evaluation of several pink, crusted papules with surrounding hyperpigmentation and a larger pink, crusted nodule with purulent drainage on her inferior right knee

For years, pediatricians have discussed with parents the important role that reading to their children plays in the development of language skills. We have encouraged talking to children about things around them, describing objects and events, and telling stories.

My teenaged patient has celiac disease and type 1 diabetes, both of which are well controlled. The patient’s mother is concerned that her son’s risk of a bowel malignancy or other celiac-related complication later in life would be significantly increased if he ingested small amounts of gluten for 5 to 7 days while at camp or on a church trip. As a result, the youngster is not allowed to participate in such outings, since it is not always possible to pack one’s own food for such trips and the available food options are usually limited.

The parents of this 8-year-old boy consult you about the warts on their son’s hands. During the examination, you discover multiple sharply defined light brown flat papules on the child’s forehead.

Prune belly syndrome is a rare condition, classically referred to as a triad of abdominal wall musculature deficiency, bilateral cryptorchidism, and other urological abnormalities, although the clinical presentation can vary. A case history here.

Asthma is the most prevalent chronic disease in children. In the United States, asthma affects approximately 1.4 million children younger than 5 years and causes frequent activity limitations and hospitalizations.