ELGENDY, MD.FAAP.
ADOLESCENT NUTRITION & OBESITY
PEDIATRX CLINIC SERVICES
Pediatric Endocrinology
Pediatric Complementary & Alternative Medicine
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JUST DIETING OR AN EATING DISORDER
More than 75% of adolescent girls report that they want to lose weight. The striking statistic underscores the importance of maintaining a high index of suspension for eating disorder. It's a progressive condition.
Anorexia Nervosa
The prevalence is 0.3%-3% of adolescent and young adult females has doubled in the last 20 years. while 90% of patients are white ,the incidence and recognition of eating disorders in teenage males, non white populations, and lower socio-economic groups appears to be increasing. It's more common among those who participate in sports, gymnestics, ballet, modeling, where size and body shape are critical to success.
Bulimia
The prevalence is 0.5%-5.0% of adolescents and young adult females. Higher incidence among whites.Patients are generaly older than anorexics, ranging from 12 years to middle aged adults.Interestingly, one third have previous diagnosis of anorexia. probably due to dysregulation of the hunger threshold, patients resort to bing eating to satisfy their overwhelming hunger, and cannot depend upon the usual satiety cues to stop eating.
Eating disorders command our attention because they are prevalent and have serious physical and emotional consequences.A considerable overlap between it's behavior and culturaly acceptable practices, dieting , eating low fat food, routine exercising. It's critical for clinicians to seek teachable opportunities to educate patients and their families.
DO you have an eating problem? please contact me for consultation.
TYROSINEMIA
A rare genetic metabolic disorder due to lack of enzyme fumarylacetacetate hydrolase [FAH].It affects males & females equaly, 1in 100,000 births in USA, higher incidence in Quebec Canada in approxmatley 1 in 1,850 births. It exibit rapid onset of symptoms, usualy begining with failure to thrive [FTT], fever, diarrhea, bloody stool, vomiting, hepato-Splenomegaly, jaundice,bruising, lethargy, irritability,developmental delay, edema, ascitis. Infants with chronic form of the disease may eventualy develop: progressive cirrhosis, hepatic failure, acute polyneuropathy, renal fanconi syndrom, hypertension, hypertrophic cardiomyopathy, hepatocellualr carcinoma.
Diagnosis may be suspected in infants who display FTT & Hepatomegaly in first 3 months of life, and confirmed through the detection of succinylacetone in the urine or decreased activity of FAH enzyme in the liver, or fibroblasts.
TREATMENT
low protein diet that contain limited tyrosine & phenylalanine, liver transplant, Orfadine [experimental drug].
