The original clinical information supplied was 'infected eczema and failure
to thrive.' On following up your suggestion the SpR informs me there was
some diarrhoea and slight vomiting.
I must confess I was not expecting any clinical laboratory in the UK to have
analytical methods available, nor do I expect elucidation of the mechanism
to help with this particular infant.
However, I do wonder how the increasing popularity of 'alternative'
medications might affect what we observe and whether our colleagues in the
East might be able to enlighten us on any biochemical consequences of such
therapies.
Trevor
> -----Original Message-----
> From: Mohammad Al-Jubouri [SMTP:[log in to unmask]]
> Sent: 13 July 2001 14:05
> To: TICKNER TREVOR (RM1) Norfolk and Norwich NHS Trust;
> [log in to unmask]
> Subject: Re: Chinese herbal medicine
>
> You did not describe the clinical secnario leading to
> his admission. Has the patient developed diarrohea and
> vomiting for example or was it just an incidental
> finding in asymptomatic baby?
> As to the herbal medicine itself, it will be beyond
> the ability of general biochemistry laboratories to
> identify the multitude of substances in such crude
> extracts. I am also not sure as to the clinical
> diagnostic benefits gained from doing so, unless toxic
> solvents have been used in its preparation and the
> clinical scenario suggests intoxication with such
> agents.
>
> regards.
>
> --- "TICKNER TREVOR (RM1) Norfolk and Norwich NHS
> Trust" <[log in to unmask]>
> wrote: > A male aged 10 months with eczema was treated
> using
> > Chinese herbal medicines
> > - one a 'herbal infusion' that was administered by
> > mouth and the second a
> > paste for application to the skin.
> >
> > On admission his Na was 117 and K 5.1. One day later
> > they were 116 and 5.7.
> > I do not know if the phlebotomy was traumatic but he
> > is 'difficult to
> > bleed'.
> >
> > He was given IV fluids ( I think principally saline)
> > and on the next 2 days
> > the results were Na 121 K 4.5 and Na 128 K 4.4.
> >
> > Random cortisols were 445 on day 2 (i.e. when Na was
> > 116) and 489 on day 3.
> >
> > Urine Na on day 3 was <5 mmol/l and K <3.
> >
> > There is a suspicion that the herbal infusion may
> > have contributed to the
> > disorder and I have now been presented with samples
> > of both the infusion and
> > the paste.
> >
> > Has anyone any (preferably polite) suggestions of
> > what I can do with these
> > samples to try to understand the electrolyte
> > disturbance?
> >
> > Many thanks,
> >
> > Trevor Tickner,
> > Norwich
> >
> >
> >
> --------------------------------------------------------------------------
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> =====
> Dr. M A Al-Jubouri
> Consultant Chemical Pathologist
> Whiston Hospital
> Prescot
> Merseyside L35 5DR
> UK
>
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