Concerns Over Slowed Growth and Unexplained Fevers
Subject: 3M, 36 inches tall, Caucasian boy. Due to worries regarding his growth, notably his shorter stature in comparison to other children his age, I opted to have some blood tests conducted. Over a period of 18 months, his height has only increased by 4 cm (1.57 inches), which seems to hover just above the minimum expected growth for this age group. The tests performed included evaluations for thyroid function and growth hormone levels, with the hormone reading at 1.0. Meanwhile, his white blood cell count was recorded at 5.1, slightly below the normal range of 5.3 to 16 as noted in the blood work results. In the past, we had conducted a blood analysis due to episodes of fevers that occurred without other symptoms. At that time, tests were administered to rule out any blood-related cancers, and thankfully, those results were negative. We don’t factor in fevers accompanied by symptoms, such as coughing—something he seldom experiences. The child generally maintains good health. We were directed to a specialist to explore potential concerns like juvenile arthritis or inflammatory diseases, but his fever patterns did not align with any specific diagnosis. After tracking these occurrences, I noted that the fevers averaged about 2.5 months apart. One worrying instance saw his temperature reach 41°C (105°F) without accompanying symptoms. Typically, his fevers hover around 38.6°C (101°F) and subside after 6 to 8 hours, usually starting around 8 PM and peaking during the night. Both forehead and oral measurements have confirmed these fever readings. Currently, he is experiencing a fever, and I've just received the latest blood test results. Naturally, I am concerned if there is a connection between all of his symptoms or if I am overthinking the situation. This particular test, which showed a white blood cell count of 5.1, was conducted roughly two weeks ago. Aside from these issues, he appears to be a generally healthy child with minimal complaints. With our impending move, I am anxious about continuity of care. If there are any additional tests we should consider, I’d like to initiate them as soon as possible.
Answers (1)
9/11/2025, 7:10:57 AM
OpenHealth AI
Your concerns about your son's slowed growth and unexplained fevers are completely valid. It’s understandable to feel anxious about his health, especially with the history of fevers and the recent blood test results. Here’s a summary of the main points and actionable steps you can take.
Summary of Key Points:
- Growth Concerns: Your son’s height increase of only 4 cm over the past 18 months is below the expected range for his age, which warrants attention.
- Fever Episodes: The recurring fevers without other symptoms, especially those that are high and come intermittently, need careful monitoring.
Explanation:
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Growth: Growth during early childhood can vary widely, and while some factors are simply genetic, others can involve hormonal or nutritional issues. The hormone test showing a level of 1.0 is something to discuss with your pediatric specialist, as there are specific ranges for growth hormone at different ages.
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Fever Patterns: The occurrence of unexplained fevers can sometimes indicate systemic processes but can also be benign in nature, especially when no other symptoms accompany them. High fevers, like the one reaching 41°C, can be concerning and should always be recorded and reported to a healthcare provider, even if they resolve quickly.
Next Steps:
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Monitor Growth: Keep track of his height and weight regularly, and document any other developmental milestones. Comparing this information can help your healthcare provider assess his growth rate accurately.
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Document Fever Patterns: Continue to log the frequency, duration, and temperature of his fevers, including how he behaves during these episodes (e.g., irritability, fatigue, activity levels after the fever). This documentation can provide valuable insights for specialists.
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Coordinate Care with Specialists: Given your son's condition, ensure a seamless transition to a new pediatric care provider when you move. Share your records, notes, and any previous test results with the new doctor. Consider keeping the specialty referral for further investigation into his fevers and growth until you have comprehensive evaluations done.
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Upcoming Tests: Apart from the blood tests already done, you might consider discussing with the specialist whether further testing is necessary, such as:
- Additional hormonal assessments (growth hormone stimulation test, IGF-1 levels).
- Imaging studies (like bone age X-ray) to understand his growth potential better.
- A comprehensive metabolic panel to explore nutritional factors.
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Communicate Concerns: If his current fever persists, especially above 39°C (102°F) for an extended period, or if you notice significant behavioral changes, seek immediate medical advice.
Your vigilance and attentiveness to his symptoms are important in managing his health. If you feel uncertain about the next steps or have specific worries as your move approaches, do not hesitate to reach out for further advice or clarification.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). 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We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.