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    What do these following lab reports indicate?

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Posted on Wed, 12 Apr 2017 in Child Health
Question: Dear sir ,
patient is 1 year 8 month boy , k/c/o Global Developmental delay , infantile Epilepsy , presented with history of cough , cold and increased drooling of secretions. in ER he had gasping breathing for which started on bag and Mask . child went into cardiac arrest requiring CPR and one dose of adrenaline after which he was revived . he was intubated and started on bag and tube ventilation and he was transported to rainbow children hospital for further management .he was admitted in PICU and started on mechanical ventilation , he was stated on IV fluid and iv antibiotic and continued on antiepileptics was started on inj Dopamine and dobutamine infusion).child could not be revived and was declared dead on 11.09.2016 .
1) Kindly guide as per available documents and investigation records . kindly guide cause of death in this case .
2) kindly provide cause of cardiac arrest in this case. is it due to global developmental delay and infantile epilepsy . is cardiac arrest is directly related to global developmental delay and infantile epilepsy.
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Answered by Dr. Diptanshu Das 2 hours later
Brief Answer:
Secondary HLH is the likely cause.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through the query and have checked the attached reports. In certain cases, possibly due to underlying genetic cause, neurodevelopmental abnormalities (including structural abnormalities of the brain) lead to delayed achieving of milestones (global developmental delay) and that was the cause of the infantile seizures as well. Mitochondrial cytopathy is estimated to be the underlying cause in this case. In such a case the overall central control of the body is impaired, thus making the individual vulnerable.

Possibly an infection or sepsis led to an life-threatening immune abnormality called Hemophagocytic Lymphohistiocytosis (HLH) which precipitated an array of problems that led to the sudden collapse. Resusticative measures were attempted but the ultimate outcome was not favorable leading to the demise.

In this case sepsis leading to HLH is to be considered the cause of cardiac arrest in a case of neurodevelopmental abnormalities possibly due to mitochondrial cytopathy.

Let me know if I could help further.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Diptanshu Das

Pediatrician

Practicing since :2005

Answered : 3821 Questions

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