CONGENITAL CHLORIDE DIARRHEA IN KUWAIT - A CLINICAL REAPPRAISAL

Congenital chloride diarrhoea (CCD) Is a recessively inherited disorde r of chloride transport in the distal ileum and colon. Congenital chlo ride diarrhoea is a common metabolic disorder in Kuwait with an incide nce of 1/3200. Clinical findings in 14 children with CCD are reported over a period of 4 years. Maternal polyhydramnios, abdominal distensio n, watery diarrhoea, and a high faecal chloride level > 90 mmol/l were the cardinal features in the neonatal period. In spite of the classic al features of this disease 75 per cent of our cases were diagnosed be yond the neonatal period and all demonstrated chronic diarrhoea and fa ilure to thrive, with hypochloraemia, hypokalaemia, and metabolic alka losis, The practice of ultrasonic examination for pregnant women with polyhydramnios and, particularly, for those with previously affected s iblings led to early identification of new cases among our population recently. The antenatal ultrasonic examination showed dilated intestin al loops which suggest CCD, The diagnosis was confirmed by a high faec al chloride level.