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Dr. Farjana Ahmed


Consultant – Pediatrics & Neonatology

Sreechand Speciality Hospital, Kannur

A urinalysis is a quick, non-invasive test that requires no special preparation. It is most commonly used to diagnose and monitor genito urinary disorders. Urinalysis can reveal diseases that have gone unnoticed because they do not produce striking signs or symptoms. One such incidental diagnosis was made recently in my outpatient department. The patient was a 6-year-old smart, well-looking girl who presented with a history of fever of 3 days’ duration and no localizing signs or symptoms. As her mother was a dentist, symptomatic management had already been initiated, and my role was to find the cause- for the intermittent fever spikes. Instead of placing the blame squarely on the shoulders of the flu virus, fortunately, I had asked her to review with a urinalysis report the same day to rule out a hidden urinary tract infection (a ritual of practicing pediatricians!). Despite her raising an eyebrow (which was expected since her child did not have any urinary complaints), I decided to proceed. As I expected, she didn’t turn out. But, as the child had her next high-grade fever spike at midnight, finally her urinalysis was done, and I received a call from the ER at 3 am to check up on her grossly abnormal report. It showed the presence of very high levels of sugars (brick-red precipitate) and ketone bodies. I immediately asked her to check the blood glucose levels, but as an expected reaction to the denial of reality, she asked me whether it could be due to a large amount of rice her daughter had for dinner. As I kept insisting, she agreed, and to her great surprise, the capillary blood glucose levels were above 600 mg/dl. Fortunately, her blood gas analysis showed features of only mild diabetic ketoacidosis. She was managed with insulin, appropriate hydration, and other supportive measures. She was investigated further and diagnosed with type 1 diabetes mellitus. Even though it took weeks for the relatives to accept the reality, finally her mother was happy that the flu turned out to be a blessing in disguise and that timely urinalysis saved her kid from a close disaster of severe diabetic ketoacidosis. Now, she is on a basal-bolus insulin regimen with well-controlled blood sugar levels.

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