K.T. Badillo. Servicio de Pediatría. Hospital Universitario de Torrejón. Mateo Inurria, s/n. 28850 Torrejón de Ardoz (Madrid).
Correo electrónico: katiebadillo@gmail.com
El presente trabajo fue presentado en formato póster en la 35 Reunión Anual de la European Society for Pediatric Infectious Diseases (ESPID), celebrada en Madrid, del 23 al 27 de mayo de 2017.

We describe the case of a seven year old male patient, who was sent to study because of recient jaundice, with final diagnosis hemolitic anemia, beginning up to 24 hours to have consumed beans, and that’s why the initial diagnosis was glucose 6 phosphate dehydrogenase deficiency (G6PD), being confirmed later. Lower numbers of haemoglobin and hematocrito appears on fourth day, remaining practically asymptomatic. Analytical normalized to 14 days. We diagnose also coexistence of G6PD with other erythropathy G6PG/HbS. The patient received the list of food and drugs potentially harmful and genetic counselling. We want to stand out the importance of reject the coexistence with another erythropathy.

Choledocholithiasis is a rare complication in patients with hereditary spherocytosis (HS) under the age of 6 years. A 5 years old girl with HS and symptomatic choledocholithiasis with spontaneous resolution is therefore discussed.

Was diagnosed of HS in her neonatal period. She had repeated hemolytic crisis and also aplastic crisis. Asymptomatic from 2 ½ years, she went to the emergency room because of mucocutaneous jaundice and abdominal pain. She had hepatosplenomegaly, hyperbilirubinemia up 29.23 mg/dL and Hb 84 g/L. Abdominal ultrasound showed cholelithiasis and choledocholithiasis.

Antibiotic treatment and ursodeoxycholic acid were given with favorable clinical and analytical outcome. She was discharged home with spontaneous ultrasound resolution. No invasive techniques were needed. We decided to delay splenectomy and cholecystectomy because of the age of the patient.

Choledocholithiasis is a rare complication in childhood. It represents only 5% in children under 5 years with HS. Only in isolated cases it resolves spontaneously. If the patient is older than 6 years old a splenectomy with cholecystectomy is the rule. There is no consensus on treatment in children under 6 years with HS who have cholelithiasis.