Child Has Headache, Abdominal Discomfort. Had VMA Spot Urine Catecholamines Done. Required Treatment?

Posted on Sat, 11 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. 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 : Dr. Chakravarthy Mazumdar

Follow up: Dr. Uma Rajah Ananth (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 : Dr. Chakravarthy Mazumdar

Follow up: Dr. Uma Rajah Ananth (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

Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

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