A few months back a 6 yr old thin boy weighing 13 kg presented with severe leg cramps since infancy and aggravates on activity and playing. The cramps partially responded to NSAIDs and relieved on rest. The boy was very fussy eater. Exam was completely normal. Thinking of metabolic disorder RBS was done which was 44 and then RPT from the other limb was 49. So hypoglycemia was confirmed. Next morning fasting sugar was 64 and pp was 76.
Both low. Then I advised to repeat sugar estimaion next morning after having full meal in the previous night.the fasting was 85 and pp 99.so after good meal in night hrs the blood sugar normalised In morning hrs.which clinched the diagnosis. For leg cramps vit d and ca was added which was low 6 and 7.8. In a month his cramps completely subsided and proper meals solved his early morning letharginess. Further 2 tests confirmed the diagnosis. Why such…
