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What Causes Inability To Gain Weight And High Fever In A Child?
Question: my 2 years old daughter has hemoglobin level of 100, she is not growing at all her weight is 6-7kg, she is very thin and quite get high fever, doctor told that she has low hemoglobin if she is not treated ,she might get animia. what is your assessment in this matter? please let me know
your opinion?
your opinion?
Brief Answer:
Have a few questions - Dont worry
Detailed Answer:
Hi XXXXXXX
I assume that hemoglobin is 10.0g/dL and not 100.
As you said she is definitely underweight. Hemoglobin would not go down with fever just like that unless it is malaria or Kala Azar or any other serious illness.
I have a few questions for you -
1. How many of fever is it now?
2. How is her activity and feeding in between fever (that is in between fevers on same day)?
3. Apart from fever what other symptoms does she have?
Kindly get back with answers to above questions and I will help you. I can assess you kid better in this way.
Regards - Dr. Sumanth
Have a few questions - Dont worry
Detailed Answer:
Hi XXXXXXX
I assume that hemoglobin is 10.0g/dL and not 100.
As you said she is definitely underweight. Hemoglobin would not go down with fever just like that unless it is malaria or Kala Azar or any other serious illness.
I have a few questions for you -
1. How many of fever is it now?
2. How is her activity and feeding in between fever (that is in between fevers on same day)?
3. Apart from fever what other symptoms does she have?
Kindly get back with answers to above questions and I will help you. I can assess you kid better in this way.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I don't know her fever , it may be 37 cel. but hemoglobin measurement in north XXXXXXX is g/L, not g/dl. she lives in Philippines, Philippines has same system as North XXXXXXX local Doctor is doing x-rays for her, and prescribed her Nebulizer and her pallets are normal, she gets fever during night time but loosing weight , that is my concerned. I live in XXXXXXX Canada, I will let you know more details 3 days later. After i get her test report from Filipino doctor. thank you very much and your informations in these regards are highly appreciated.
regards, XXXX
regards, XXXX
Brief Answer:
Looks like a viral illness
Detailed Answer:
Hi XXXXXXX
Do not be concerned about her hemoglobin as 10g/dL and 100g/L doesn't make any difference...its the same. About the wheezing part nebulizer is fine and let me know about the X-ray reports and if possible upload the X-ray images.
Regarding her weight loss - I would like to know how much she has reduced and in how much time...the answer to this question makes a lot of difference.
Waiting for your reply and X-ray in 3 days.
Regards - Dr. Sumanth
Looks like a viral illness
Detailed Answer:
Hi XXXXXXX
Do not be concerned about her hemoglobin as 10g/dL and 100g/L doesn't make any difference...its the same. About the wheezing part nebulizer is fine and let me know about the X-ray reports and if possible upload the X-ray images.
Regarding her weight loss - I would like to know how much she has reduced and in how much time...the answer to this question makes a lot of difference.
Waiting for your reply and X-ray in 3 days.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
the x-ray report shows negative, everything id good as far her chest is concern, her temperature is coming during night time exactly at 10.00 P.M. everysay, it is measured 38.9 C, she is not gaining any weight since last 7 months, her weight right now 6 kg, and she is 1 year 9 months old, I asked her mother to check blood in order to find any malaria parasites in her blood stream, and also for hay fever, she advised her to ask her pediatrician to test malaria or some dangue fever. her platelet is high, if you need more information please ask me what else do toy need to report you, your cooperation in these regards is very valuable and I do appreciate your feedback, thank you very much.
Regards,
XXXX
the x-ray report shows negative, everything id good as far her chest is concern, her temperature is coming during night time exactly at 10.00 P.M. everysay, it is measured 38.9 C, she is not gaining any weight since last 7 months, her weight right now 6 kg, and she is 1 year 9 months old, I asked her mother to check blood in order to find any malaria parasites in her blood stream, and also for hay fever, she advised her to ask her pediatrician to test malaria or some dangue fever. her platelet is high, if you need more information please ask me what else do toy need to report you, your cooperation in these regards is very valuable and I do appreciate your feedback, thank you very much.
Regards,
XXXX
Brief Answer:
Suggestions and Plan of action
Detailed Answer:
Hi XXXXXXX .
I have gone through the details XXXXXXX ..Some kids who are born with low or extremely low birth weight will definitely have a lower current weight, but even then 6 kg is too low for a 1 year 9 month old. If I were your treating pediatrician, these are my observations and suggestions -
Possibilities - (I have explained what to do for each of these)
1. Tuberculosis
2. Renal Tubular Acidosis
3. Mal-absorption/ Inflammatory bowel disease.
4. Immunodeficiency.
1. A 1year 9 month old kid weighing 6 kg is very less for her age, but getting fever daily and not gaining weight is something to be looked into. I would consider the possibility of Tuberculosis and do the following tests (as Chest X-ray is already reported as normal) - Mantoux test on the left fore arm with 1 or 2 TU strength.
2. The other possibility I would consider is - Renal tubular acidosis and will do a Renal function test and urine dispstic for this.
3. Mal-absorption too is a possibility and I suggest you to do Liver function tests and serum Albumin and she will need a gastroenterology consult to rule out inflammatory bowel disease.
4. Immunodeficiency thought the least possibility has to be definitely c0onsidered as she is failing to thrive without any proper reason. For this I would prefer to do an Immunoglobulin profile and a Flow cytometry for T and B cell markers in her blood.
This completes her work up and if everything is normal, you can be rest assured that low food intake is the only one which is responsible for her underweight.
If you are happy with my suggestions, kindly rate it.
Regards - Dr. Sumanth
Suggestions and Plan of action
Detailed Answer:
Hi XXXXXXX .
I have gone through the details XXXXXXX ..Some kids who are born with low or extremely low birth weight will definitely have a lower current weight, but even then 6 kg is too low for a 1 year 9 month old. If I were your treating pediatrician, these are my observations and suggestions -
Possibilities - (I have explained what to do for each of these)
1. Tuberculosis
2. Renal Tubular Acidosis
3. Mal-absorption/ Inflammatory bowel disease.
4. Immunodeficiency.
1. A 1year 9 month old kid weighing 6 kg is very less for her age, but getting fever daily and not gaining weight is something to be looked into. I would consider the possibility of Tuberculosis and do the following tests (as Chest X-ray is already reported as normal) - Mantoux test on the left fore arm with 1 or 2 TU strength.
2. The other possibility I would consider is - Renal tubular acidosis and will do a Renal function test and urine dispstic for this.
3. Mal-absorption too is a possibility and I suggest you to do Liver function tests and serum Albumin and she will need a gastroenterology consult to rule out inflammatory bowel disease.
4. Immunodeficiency thought the least possibility has to be definitely c0onsidered as she is failing to thrive without any proper reason. For this I would prefer to do an Immunoglobulin profile and a Flow cytometry for T and B cell markers in her blood.
This completes her work up and if everything is normal, you can be rest assured that low food intake is the only one which is responsible for her underweight.
If you are happy with my suggestions, kindly rate it.
Regards - Dr. Sumanth
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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