Wilms' Tumor and Hypoglycemia
Answer: D.
The presentation of a young child with insidious abdominal pain, flank mass, and hematuria is indicative of a Wilms’ tumor. A large tumor burden such as in Wilms or neuroblastoma may cause hypoglycemia, due to increased demand. The causes of hypoglycemia in children are many; a selected list includes:
The presentation of a young child with insidious abdominal pain, flank mass, and hematuria is indicative of a Wilms’ tumor. A large tumor burden such as in Wilms or neuroblastoma may cause hypoglycemia, due to increased demand. The causes of hypoglycemia in children are many; a selected list includes:
One ampule of D50 contains 25 g of glucose, and is suitable for adult administration. Smaller veins tolerate lower osmotic loads. The typical neonatal acute dosing of glucose is 5-10 mL/kg of D10. The acute dose for a child is 2-4 mL/kg D25. Children with profound hypoglycemia will then need maintenance dosing and frequent monitoring.