From Modesto, California, USA:
I have a 15 year old son who was diagnosed type 1 at the age of twelve. He has a strange health history and I was wondering if he should be tested for any other conditions. When I was pregnant with him I was diagnosed with polyhydramnios. A glucose tolerance test was negative and a sonogram did not show any physical abnormalities. He weighed 9.5 lbs. and was 23.5 inches long at birth and was jaundiced until put under the lights. In most ways he seemed just fine but he had to nurse (or take a bottle) every two hours until about 21 months. He was also extremely sensitive to sound, light, and motion. I couldn't look at him or rock him while he took the bottle or he would become very upset. No one else could hold him, either, from the day he was born.
He had several illnesses before the age of 18 months, including mono and shingles. After I took him off the bottle at age 2 he started having low blood sugar attacks. At first I didn't know what they were. They occurred most often first thing in the morning with fainting, cold sweat, nausea, and heart palpitations. They seemed to be worst when he had eaten a lot of fruit the day before. I took him to the doctor several times before he did blood sugar testing and then documented sugars in the 40's. My son seemed healthy and normal in every other way, though, with height in the 90% and weight in the 50% and IQ over 150. The doctor just said to make sure he got a good breakfast. He started school and did well and adjusted to having so many people around although he is still on the quiet side. At the age of 9 a pediatric endocrinologist came to town and my son's doctor wanted him to be seen.
The endo put him in the hospital overnight and tried to induce hypoglycemia and was unable to, in fact, he said, my son's insulin was on the low side. We were looking too hard to find something wrong with out son's health and it just wasn't there. (By the way, our oldest son, now 17, has a mild form of cystic fibrosis and our daughter, now 12, seems to have developed under-activity of several endocrine glands.) About a year later, our son started to develop a bronze color in his skin with darkening over his upper lip. He is fair with red hair and blue eyes. It looked like a sickly tan. The only time he felt good was after he had been playing something like football. He continued to grow but stopped putting on weight (or not much). The doctors could not find anything wrong until he had the classic symptoms of diabetes: weight loss, thirst, urination, stomach pain, etc. He was put on insulin but no antibody tests have been done. He seems to be doing fine now. He is 5'11" and 120 lbs., on the pump and Humalog and his skin color is normal and he is a freshman in high school. I can't help wondering, though, about the hypoglycemia and bronzing of his skin and if there is anything we might have overlooked. Do you have any ideas?
I have to say that I was a little bewildered by this complicated history of a young man I had never seen. What caught my eye however was your description of the bronzing of his face. It seems to me that he might be a case of 'Autoimmune Polyglandular Syndrome Type 2' (APS-II). The diabetes of course fits in with this and other endocrine glands might be involved. The coloration of his face suggests that his suprarenal [adrenal] glands are affected (Addison's Disease). These young people do very well with appropriate treatment; but it is particularly important to do the necessary tests for 21-hydoxylase antibodies in the blood. This is quite easy to treat; but it is also possible to become suddenly very sick with a random infection if you don't know about the possibility and haven't taken the easy steps to prevent it.
I have a feeling that your daughter may have the same problem and just has not yet developed diabetes. It is even possible that your eldest son has the same thing only a variant where there is celiac disease and a test for anti transglutaminase in serum is needed. However if he did indeed have CF confirmed by a sweat chloride test then that possibility is unlikely.
Please don't be alarmed by all of this rather complex talk; but do talk to the doctor about the possibility as soon as you can.
Original posting 27 Mar 1998
Posted to Other Illnesses
Last Updated: Tuesday April 06, 2010 15:08:56
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