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Child has headache, abdominal discomfort. Had VMA spot urine catecholamines done. Required treatment?

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Pediatrician, Neonatology
Practicing since : 1970
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Hi, my daughter recently had VMA spot urine catecholamines done Her results were as follows: everything within normal ranges except: urine creatinine 3609 umol/ml and 5-hiaa 13 (normal range 5-7). It said at bottom of urine report that creatinine was measured in mmol/mol. She is aged 10, has sporadic blood pressure (145/100at highest ) and headaches, abdomen discomfort, foul smelling diarrhaoea, consistently. She has a PFO in her heart but it isn't significant.Her paediatrician doesn't seem concerned because ultrasound of kidneys seems fine. Could there be a problem? Very worried mum. Her younger sister aged 9, also has had severe bilateral pain in the long bones/muscles of her limbs - arms and legs for past two years only on exertion, and still undiagnosed. her bloods were all normal except her creatinine : 77 and again, also urine creatinine in thousands range. She also has itchy, spots that occur only on her face and hands and has PAC's in the heart, but not significant. Could there be a link between the two girls?
Posted Fri, 10 May 2013 in Child Health
 
 
Answered by Dr. Uma Rajah Ananth 58 minutes later
Hi
Welcome to HCM!

Your child with the above mentioned problems needs a pediatric endocrinologist /metabolic specialist consultation.
A normal ultrasound rules out adrenal tumours.
I think carcinoid should be excluded.

If two of them in the family have similar problems ,the metabolic causes are more likely.
The spot tests ,sometimes need confirmation with 24 hrs specimen.

These tests have to be intepreted with clinical symptoms and signs.
I see that you are from Ireland!
Please try to get appointment in an university hospital where you can gain access to multispeciality pediatric doctors and where all investigations are available.
Good luck
God bless

Above answer was peer-reviewed by
 
Follow-up: Child has headache, abdominal discomfort. Had VMA spot urine catecholamines done. Required treatment? 47 minutes later
Thanks so much for that. I wonder if you know if there are any paediatric metabolic/endocrinologist specialists on this site that could help me narrow down what types of disorders could be possible? If I am to ask for a referral from my GP/paediatrician I would like to give more information?

I really appreciate your advice,

God Bless
XXXXXX
 
 
Answered by Dr. Uma Rajah Ananth 8 hours later
Hi,
Sorry,
I am not aware of anyone with those specialties on this site.
These specialists are very few and are usually in university hospitals .
If I come across someone I will let you know.
Good luck
Dr Uma
Above answer was peer-reviewed by
 
Follow-up: Child has headache, abdominal discomfort. Had VMA spot urine catecholamines done. Required treatment? 35 hours later
Thank you so much Dr Uma
XXXXXX
 
 
Answered by Dr. Uma Rajah Ananth 2 hours later
Welcome.
Wish your kids all the best.
Bye
Dr Uma
Above answer was peer-reviewed by
 
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