Internal Medicine

P1: RLJ/OZN P2: KUF

0521779407-D-01 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 7:41

468 Dementia Dent’s Disease

■Metabolic disorders: blood studies differentiate hypothyroidism,

vitamin B12 deficiency, hepatic & renal failure

■Vascular disorders: brain imaging excludes chronic subdural

hematoma & multi-infarct dementia

■Head trauma: severe open or closed head injury

■Behavioral disorders: history & neuropsychological testing exclude

pseudodementia

management

■Reduce or stop meds that may exacerbate cognitive problems

■Follow Mini-Mental Status Examination

specific therapy

■Depends on cause

follow-up

N/A

complications and prognosis

■Depend on cause

Dent’s Disease......................................

MICHEL BAUM, MD

history & physical

■Recurrent renal stones, may have failure to thrive and rickets

■Progressive renal insufficiency

tests

■Low-molecular-weight proteinuria, nephrocalcinosis, may have

rickets

■May have glucosuria, amino aciduria and phosphaturia (acidosis is

rare)

■Most have hypercalciuria

differential diagnosis

■X-linked recessive defect in proximal tubule chloride channel

(CLCN5)

■Distinguish from other causes of proteinuria and nephrolithiasis

management

■Fluid intake, low-salt diet