Appendix 44 - Acute presentations to A & E - in Down Syndrome

  1. Infections, recurrent infections and Sepsis - can present atypically

  2. Aspiration - any dysphagia? GORD?

  3. Anaemia, recurrent infections, unexplained bleeding/bruising - consider Leukaemia

  4. Cardiac failure/cardiac presentation from congenital cardiac disease

  5. Abnormal movements - could this be infantile spasms? Seizures?

  6. Loss of motor skills, fine and or gross motor - consider Atlanto-axial instability (AAI)

  7. Pain in back/neck and reduced range of movement - consider AAI

  8. Weight loss/abdominal pain/constipation/diarrhoea - consider Coeliac

  9. Tiredness, lethargy, weight change, behaviour change, hair changes - consider thyroid disease.

  10. Palpitations, high fever, feeling very agitated and confused - consider Thyroid storm/crisis

  11. Regression in skills, change in behaviour - consider DS Disintegrative disorder, autism, early dementia (as well as all the above and what might be the cause in people without Down Syndrome)