P87 The use of ophthalmic atropine sublingually for the relief of sialorrhea in two pediatric patients

Abstract

Clinical Case Our case represents a previously fit 17-year-old male. Retrospectively admitting to some fatigue, he was actively playing sports with no background/family history. Blood tests performed at a GP practice, at the time of investigation for a swollen knee/sports injury, reported a serum creatinine > 1000mmol/L and subsequent urine analysis reported >3 g of protein in 24 hours. Dialysis was initiated due hyperkalaemia, rising creatinine and uraemia and a renal biopsy reported greater than 90% fibrosis. A PTH level was reported greater than 300ng/L, indicating that renal impairment had been progressing for some time. Initial vasculitic and autoimmune serology have all been reported as negative, and our patient is currently being worked up for a renal transplant. Discussion This case represents ESKD due to idiopathic IN. IN is steroid responsive and when diagnosed and treated promptly, renal impairment can be limited. Unfortunately, in our case, there was no indication to perform urine or serum analysis, which may have prompted earlier intervention. This highlights the possible benefits for routine screening in the community. As well as medical issues associated with renal impairment and transplantation there are also huge psychosocial implications for an adolescent including compliance with medications and self-image post transplantation, (Abdel-Kader, et al., 2009) .