Pediatric SEQs

Pediatric SEQs

A 12‐year‐old boy presented with obesity. He had been floppy and a poor feeder as an infant with recurrent fits until the age of seven years. On examination, he had developmental delay and special educational needs. His height was on the 50th centile and weight well above the 97th centile.

The following measurements were obtained on a basal blood sample:

Calcium 1.95mmol/L [7.82 mg/dL]

Albumin 41 gL [4.1 g/dL]

Phosphate 1.90mmol/L [5.9 mg/dL]

Creatinine 78μmol/L [0.9 mg/dL]

Alkaline phosphatise 202 IU/L (reference range 100–400)

PTH 14.5pmolL (reference range 0.9–5.5) [138 pg/ml (reference range 10–65)] 25‐OH‐cholecalciferol 16.1 ng/ml (reference range 8–50)

Free T4 11pmol/L (reference range 9.8–23.1) [0.88 ng/dL (reference range 0.8–2.4)]

TSH 5.7mU/L (reference range 0.35–5.5)

Questions and Answers

1.      What do these results demonstrate?

2.      What is the most likely diagnosis?

3.      What additional investigations may clarify the diagnosis?