Differential Diagnosis for Daytime Urinary Incontinence and Below 5th Percentile Weight and Height in a 5-year-old Boy
- Single Most Likely Diagnosis
- Neurogenic bladder due to spina bifida or other spinal cord anomalies: This condition can cause urinary incontinence due to the nerve damage affecting bladder control. The below-average weight and height could be related to associated conditions or complications such as mobility issues or gastrointestinal problems.
- Other Likely Diagnoses
- Urinary tract infections (UTIs): Recurrent UTIs can cause urinary incontinence, and if left untreated, could potentially lead to growth delays due to chronic illness.
- Constipation: Chronic constipation is known to cause urinary incontinence in children due to the pressure it puts on the bladder. It can also lead to decreased appetite, affecting growth.
- Diabetes insipidus or mellitus: Both conditions can cause polyuria leading to incontinence. Diabetes mellitus, in particular, if uncontrolled, can lead to growth delays.
- Do Not Miss Diagnoses
- Tumor or mass in the spinal cord or brain (e.g., neuroblastoma, brain tumor): These can cause neurogenic bladder and, depending on their location, can affect growth hormone production or lead to increased intracranial pressure, both of which can impact growth.
- Congenital adrenal hyperplasia: This condition can lead to growth issues and, in some cases, urinary incontinence due to associated neurological or anatomical abnormalities.
- Rare Diagnoses
- Williams syndrome: A genetic disorder that can cause growth delays, and while less commonly associated with urinary incontinence, it can occur due to associated neurological or anatomical issues.
- Prader-Willi syndrome: Characterized by severe infantile hypotonia and poor feeding, leading to growth delays. Urinary incontinence can be a feature due to potential neurological impacts on bladder control.