Petechiae with young onset Diabetes under Ix Chief Complaints A 17 yr old male has come with non pruritic, non palpable Petechiaeal lesions over upper n lower limbs and abdomen since 2 weeks. No associated Fever, cough, abdominal pain, arthralgia, bleeding episode, chest pain, hemoptysis, frothing of urine, headache, neck rigidity, LOC, Nsaid or any oral anticoagulant intake, substance abuse etc. No significant past H/O. Routine Ix were advised like CBC, LFT, RFT, Sr Electrolytes, BT, CT, PT/INR, Urine RE, PBS, ESR, CRP, Dengue, Malaria, HBsAG and anti HCV. USG W/A. All reports are normal except raised FBS of 178 and sugar +++ in urine. His father is suffering from T2DM, no other significant family history. I have also advised for ANA, ANCA and other Ix. Pt is also having gynaecomastia with increased BMI. What's ur take on this case.. Is the guy suffering from MODY... N what's the cause for petechiae. Diagnosis https://youtu.be/OeDyiD_7Q1Y

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May consider advising Platelet function studies to rule out thrombasthenia and MRI brain to rule out any pituitary or hypothalamic lesion. HbA1c to determine the chronicity of hyperglycemia. A watchful syndromic approach may be helpful.

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Go for Genetic test to know MODY, advice HBa1c, Adv Hormonal assay, Auto immune Disorder ? Check it  type 2 diabetes in adolescents and young adults is common Infections & reactions to medications are common causes of petechiae Start with Steroid Levocet+M

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?SLE, ?Auto Immune Disorder ?Thrombocytopenia

How about going for a stimulated C-peptide test and GAD Abs too? I think meanwhile you can start him on low dose SU's

Adv hormone assay And connective tissue disorder panel.

Vasculopathy Atarax Levocet Sos steriod

DIABETIC NEPHROPATHY WITH VASCULOPATHY DOPPLER STUDY GO FOR HORMONAL ASSAY TO RULE OUT MODY OR T2DM STRAT SU ACCORDING TO HORMONAL ASSAY

Seems Heat allergy -Nat Mur can cure it

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