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Child Has Headache, Abdominal Discomfort And Diarrhea. VMA Spot Urine Catecholamines Done. Suggestion

Posted on Mon, 13 May 2013

Question: 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?

Answered by Dr. V. Kumaravel (4 hours later)

Hello

I do understand your concern regarding your daughters high urine creatinine and sporadic BP. I presume urine creatinine was done as a work-up for hypertension.

We generally order a urine creatinine test in combination with other urine tests, Because creatinine is filtered out at a fairly steady rate, we compare the creatinine level with levels of other substances in the urine to determine if they're being excreted at a normal rate. Just increase in urine creatinine may not be clinically significant.

Regarding 5 HIAA, we can have many false positive and it has to be interpreted in the context of patients clinical presentation.

Hypertension at this age definitely requires detailed evaluation. I agree kidney ultrasound is normal, but further kidney function tests and kidney vascular Doppler test, cardiac evluation and blood electrolytes may be required. If all of them are normal, we have to monitor your child periodically and nothing much to be worried.

Regarding your younger daughter, she also requires evluation and it is very difficult to comment without seeing the patient.

regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. V. Kumaravel (33 hours later)

Thank you so much for that information, I really appreciate that.

Answered by Dr. V. Kumaravel (26 hours later)

Thank you madam. If have any further query, please do not hesitate to contact us.

regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar