We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Special Feature |

Pathological Case of the Month FREE

Ahmet Karadag, MD
[+] Author Affiliations

Section Editor: Enid Gilbert-barness, MD

More Author Information
Arch Pediatr Adolesc Med. 2002;156(3):291. doi:10.1001/archpedi.156.3.291.
Text Size: A A A
Published online

A 7-MONTH-OLD BOY with malnutrition and chronic diarrhea came to the emergency department with dehydration and metabolic acidosis. His medical history revealed that he had diarrhea, vomiting, and abdominal distension for 1½ months. His stool was defined as foul-smelling, greasy, and bulky. He was born from nonconsanguineous parents following an uneventful pregnancy. He had been breastfed until he was 3 months old, at which time he began receiving formula, rice, and biscuits.

At physical examination, his weight was 5800 g (<3rd percentile), his height was 68 cm (<75th percentile), and his head circumference was 42 cm(<10th percentile). He was dehydrated and his abdomen was severely distended but there was no organomegaly. Results of laboratory investigations were compatible with metabolic acidosis and mild hypokalemia. A complete blood cell count showed hemoglobin to be 11.4 g/dL; hematocrit, 35.3%; mean corpuscular volume, 71.9 fL; white blood cell count, 9.2 × 103/µL (9.2 × 109/L); and platelets, 220 × 103/µL (220 × 109/L). A peripheral blood smear revealed 36% granulocytes, 52% lymphocytes, 10% monocytes, 2% bands, and generalized acanthocytosis was noticed, involving more than 80% of erythrocytes (Figure 1).


Accepted for publication April 18, 2000.

Corresponding author: Ahmet Karadag, MD, Department of Pediatrics, Fatih University Medical School, Ciftlik Caddesi No. 57 06510, Emek Ankara, Turkey (e-mail: kara_dag@hotmail.com).




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

2 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
[Clinical studies of pediatric malabsorption syndromes]. Fukuoka Igaku Zasshi 2006;97(11):322-50.