Ask the expert

tada

Body odor and bloody diaper


Question

My daughter recently developed extreme body odor similar to that of a sweaty adult and blood in her diaper. Could these be related or due to precocious puberty? What follow up is recommended? We are scheduled to see an endocrinologist.

Answer of our experts

First of all, there are several metabolic conditions (conditions caused by an abnormality in one of the hundreds of body enzymes producing specific symptoms in the individual) that can produce an odor like sweaty feet. These can be screened for by a test on urine called organic acids and a blood test called plasma amino acids. These tests are most effective when the odor is present, or if the child is ill. Just because someone has CdLS, it does not necessarily mean that they couldn't have something else. Metabolic conditions can be quite severe, with seizures and neurologic problems, but there can be partial defects in which the symptoms arenot so severe, and an unusual odor could be a tip-off.

Regarding the blood in the diaper, I cannot tie that in with either the odor or the CdLS. I would make sure you bring the blood to the doctor to have it tested to make sure it is blood (probably already did this). There are a number of potential causes of blood in the diaper: blood from urine (urinary tract infection, kidney infection, diseases of the kidney that also have other findings in the urine and body), blood from bowel (fissures or cracks in the rectal area, internal fissures, hemorrhoids, infections, other bowel diseases often presenting with diarrhea, etc.) or blood from the female genital tract (very unlikely at such a young age). I would not attribute this to precocious puberty unless there is also lots of pubic hair and other pubertal changes. Still, if some of this has already been worked up by your doctor, then a referral to endocrinology is reasonable.

TK 7-13-10

Answer is checked and valid for
us

Recommendation(s)

Pain and Behaviour

R18
As pain can easily remain unrecognised in a child with CdLS, all care providers should be aware of the different manifestations and the possible sources of pain. Specific tools to assess pain are recommended.

Recommendation(s)

Can individuals with CdLS have children?

R20
Sexual education appropriate to the level of understanding should be offered, and contraception management should follow local standard for the general population.
R21
Hysterectomy is indicated if abnormally heavy bleeding at menstruation is present and does not respond to medical treatment.

Legal Disclaimer

Please take note that the Ask the Expert service is comprised of volunteer professionals in various areas of focus. Answers are not considered a medical, behavioral, or educational consultation. Ask the Expert is not a substitute for the care and attention your child’s personal physician, psychologist, educational consultant, or social worker can deliver.

Do you have a question you would like to ask?

Ask a Question

Do You urgently need help? Contact the CdLS Foundation USA, Our Staff!