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# Mometrix ## Alterations in consciousness - Seizures (rare) - Bleeding from the nose or mouth occurs as platelets decrease and clotting time increases - Hypertension - Edema - Paralysis (cerebral blood clot) ### Note: Mortality rates are 3-5%, but chronic renal problems develop in 50% and a few...

# Mometrix ## Alterations in consciousness - Seizures (rare) - Bleeding from the nose or mouth occurs as platelets decrease and clotting time increases - Hypertension - Edema - Paralysis (cerebral blood clot) ### Note: Mortality rates are 3-5%, but chronic renal problems develop in 50% and a few have lifelong complications, including blindness, paralysis, and kidney failure requiring dialysis. Treatment is as follows: - Antibiotics are contraindicated unless sepsis is present because they may increase release of toxins associated with E. coli - Intravenous fluids and nutritional supplements - Blood transfusions may be needed - Plasmapheresis is sometimes used to remove antibodies from the blood - Protein limitation and ACE inhibitors to prevent permanent kidney damage ## Celiac Disease Screening Celiac disease is gluten-sensitive enteropathy with a chronic malabsorption syndrome caused by damage to the villi from toxic reactions to gluten in wheat, barley, rye, and oats. Symptoms normally don't appear until the child begins a diet of solid foods and exhibits chronic diarrhea, vomiting, and failure to thrive. A careful family history may indicate a genetic disposition, but these warning symptoms should trigger screening even without such history. Additionally, 4-13% of children with trisomy 21 (Down syndrome) have celiac disease, so screening is recommended for all infants with trisomy 21. Identifying children with celiac disease early and providing dietary counseling for the parents can prevent the damage to the intestines that will otherwise occur. Parents and eventually the child should be taught dietary substitutions and referred to national organizations, such as the American Celiac Society and the Celiac-Sprue Association, which can provide information and support. ## Malabsorption ### Celiac Disease Autoimmune disorder with intolerance to gluten, which causes destruction of surface epithelium of the small intestine. Symptoms include: - Loss of weight - Diarrhea, bloating, steatorrhea (fatty stools) - Azotorrhea (nitrogenous wastes in stool/urine) - Anemia - Vitamin/Iron deficiency (folate, B12) ### Treatment is a gluten-free diet ## Lactose Intolerance Deficiency of intestinal lactase causes increased lactose in intestine. Symptoms are diarrhea and cramping. Treatment is oral lactase (Lactaid®) and a dairy-free diet.