A DISTROPHIC INFANT WITH METABOLIC ALKALOSIS

Key words: Distrophic infant, Blood gas analysis, Metabolic alkalosis, Differential diagnosis

We describe a case of a 4 months-old girl who come to our attention because of an history of failure to thrive and recurrent vomiting started during the second month of life; only remarkable laboratory data were the presence of hyponatriemia and hypochloremia. Physical examination showed a miserable looking child, with a weight under the 3rd percentile; blood gas analysis revealed a metabolic alkalosis. We report this case not because of its difficult diagnosis, but as an example of clinical course in the interpretation of failure to thrive during the first months of life; in this report we analyze the importance of some laboratory examinations (blood gas analysis) and the main aspects of some diagnostic hypothesis (hypertrophic pyloric stenosis, metabolic inborn errors, 21-hydroxilase deficiency).