Konggrapun Srisuwan

Delta F508 mutation is recognized as the most common genotype of cystic fibrosis (CF) however, there are small numbers of CF patients having Delta F508/F311L. In the present study, the authors report a 2-year-old Thai boy, originating from North India, presenting with recurrent episodes of febrile illness, hyponatremia, hypokalemia, and metabolic alkalosis since 4 months of age. He was transferred to our hospital for further investigation. Blood chemistry revealed the following serum electrolytes, sodium 122, potassium 3.69, chloride 79.7, and bicarbonate 33.8 mEq/L, and the following urine electrolytes, sodium < 10, potassium 45.7 and chloride < 10 mEq/L. After intravenous fluid administration, hyponatremia and metabolic alkalosis improved DNA sequencing analysis of his blood demonstrates compound mutation for Delta F508 and F311L in CFTR gene. In conclusion, the authors report a rare case of CF with Delta F508/F311L genotype presented with recurrent hyponatremia and metaboli...

Volume overload from an incorrect assessment of dry weight leads to cardiovascular diseases in chronic hemodialysis patients. Dry weight assessment in pediatric is difficult for a number of reasons including growth. Blood volume monitoring (BVM) has been proposed as an accurate method of estimating dry weight in adult. However, there is very scant data regarding B VM assessment in pediatric. Therefore, the authors conducted a study to compare dry weight, postdialytic body weight, predialytic blood pressure, intradialytic blood pressure, and intra dialytic symptoms between clinical adjustment and B VM method. In pediatric chronic hemodialysis patient, B VM was performed to guide ultrafiltration to adjust dry weight compared with clinical adjustment. Data including dry weight, postdialytic body weight, predialytic blood pressure, intradialytic hypotension, and intradialytic symptoms were analyzed over each 1-month period of treatment course. Ten patients (5 males/5 females, age 16.55 ...

Delta F508 mutation is recognized as the most common genotype of cystic fibrosis (CF) however, there are small numbers of CF patients having Delta F508/F311L. In the present study, the authors report a 2-year-old Thai boy, originating from North India, presenting with recurrent episodes of febrile illness, hyponatremia, hypokalemia, and metabolic alkalosis since 4 months of age. He was transferred to our hospital for further investigation. Blood chemistry revealed the following serum electrolytes, sodium 122, potassium 3.69, chloride 79.7, and bicarbonate 33.8 mEq/L, and the following urine electrolytes, sodium < 10, potassium 45.7 and chloride < 10 mEq/L. After intravenous fluid administration, hyponatremia and metabolic alkalosis improved DNA sequencing analysis of his blood demonstrates compound mutation for Delta F508 and F311L in CFTR gene. In conclusion, the authors report a rare case of CF with Delta F508/F311L genotype presented with recurrent hyponatremia and metaboli...

OBJECTIVE Volume overload from an incorrect assessment of dry weight leads to cardiovascular diseases in chronic hemodialysis patients. Dry weight assessment in pediatric is difficult for a number of reasons including growth. Blood volume monitoring (BVM) has been proposed as an accurate method of estimating dry weight in adult. However, there is very scant data regarding B VM assessment in pediatric. Therefore, the authors conducted a study to compare dry weight, postdialytic body weight, predialytic blood pressure, intradialytic blood pressure, and intra dialytic symptoms between clinical adjustment and B VM method. MATERIAL AND METHOD In pediatric chronic hemodialysis patient, B VM was performed to guide ultrafiltration to adjust dry weight compared with clinical adjustment. Data including dry weight, postdialytic body weight, predialytic blood pressure, intradialytic hypotension, and intradialytic symptoms were analyzed over each 1-month period of treatment course. RESULTS Ten p...

Serum electrolytes and urine analysis results were retrospectively reviewed in children with either dengue fever (DF) or dengue hemorrhagic fever (DHF). Children who had positive serology for dengue infection and serum electrolytes determined before starting intravenous fluid were included in the study. During the years 2004-2007, 73 DF patients, age 9.29 +/- 3.62 years, and 77 DHF patients, age 10.04 +/- 3.64 years were enrolled in the study. The patients were admitted to the hospital on average on days 4.12 +/- 1.1 and 4.25 +/- 1.4 of febrile illness for DF and DHF, respectively. The prevalence of hyponatremia in patients with DF was 61% and DHF was 72% (p = 0.149). The mean serum sodium levels in patients with DF and DHF were 133.5 +/- 3.52 and 133.5 +/- 3.20 mEq/l (p = 0.938), respectively. The prevalence of hyponatremia in patients with mild (grade I), moderate (grade II) and severe (grade III-IV) DHF were 70, 77, and 78% (p = 0.729), respectively, and the mean serum sodium lev...

Background Vitamin C deficiency is common in chronic kidney disease (CKD) due to losses through dialysis and dietary intake below requirement. We investigated prevalence of vitamin C deficiency and impact of vitamin C treatment in deficient/insufficient patients. Methods A prospective cohort study in patients aged 1–18 years with CKD stages 4 and 5D collected demographic data including underlying disease, treatment, and anthropometric assessment. Vitamin C intake was assessed using 24-h dietary recall. Hemoglobin, iron status, serum vitamin C, and serum oxalate were measured at baseline and after treatment. Vitamin C (250 mg/day) was given orally for 3 months to deficient/insufficient patients. Results Nineteen patients (mean age 12.00 ± 4.1 years) showed prevalence of 10.6% vitamin C insufficiency and 78.9% deficiency. There were no associations between vitamin C level and daily vitamin C intake ( p  = 0.64) or nutritional status ( p  = 0.87). Median serum vitamin C was 1.51 (0.30–...

Volume overload from an incorrect assessment of dry weight leads to cardiovascular diseases in chronic hemodialysis patients. Dry weight assessment in pediatric is difficult for a number of reasons including growth. Blood volume monitoring (BVM) has been proposed as an accurate method of estimating dry weight in adult. However, there is very scant data regarding B VM assessment in pediatric. Therefore, the authors conducted a study to compare dry weight, postdialytic body weight, predialytic blood pressure, intradialytic blood pressure, and intra dialytic symptoms between clinical adjustment and B VM method. In pediatric chronic hemodialysis patient, B VM was performed to guide ultrafiltration to adjust dry weight compared with clinical adjustment. Data including dry weight, postdialytic body weight, predialytic blood pressure, intradialytic hypotension, and intradialytic symptoms were analyzed over each 1-month period of treatment course. Ten patients (5 males/5 females, age 16.55 ...