Pittsburgh hospital service specializes in pediatric mysteries

Monday, January 3rd 2005, 11:28 am

By: News On 6

PITTSBURGH (AP) _ A child suffered from abdominal pain and migraine headaches that his pediatrician couldn't diagnose. So his parents took him to the Paul C. Gaffney Diagnostic Referral Service, where medical sleuths solve pediatric mysteries that stump regular pediatricians.

Gaffney, a service of Children's Hospital of Pittsburgh, sees about 1,600 patients annually with everything from constipation to rare metabolic diseases, said Dr. Basil Zitelli, who heads the group.

``It's phenomenal what walks in here,'' he said.

The service, named for the late pediatrician who founded the practice in 1951, is the oldest and largest of its kind in the country. The model has been copied in children's hospitals across the country, such as St. Christopher's in Philadelphia and Alfred I. duPont Hospital in Wilmington, Del.

``If I have something that's a little bit out of the ordinary and a little more involved, I call the diagnostic referral group,'' said Dr. Donald J. Vigliotti, of Children's Community Pediatrics, with offices in Armstrong and Butler counties. ``They are a great service that we rely on when we need more expertise.''

By the time a patient is referred to Gaffney doctors, most easy answers have been eliminated. Sometimes, its doctors can immediately diagnose a disorder because they see it regularly, whereas a private practice pediatrician might see it once in a career.

In the case of the boy with abdominal pain and migraines, doctors tested the child's lead levels, which proved to be abnormally high. But his parents said there was no chance their son had come across lead-based paint chips or leaded dust.

Because of the child's complaints of stomach pains, Zitelli ordered an X-ray, which revealed the boy had swallowed a toy ring made of lead.

``It's an intellectual challenge, like a chess game,'' said Dr. Andrew Urbach. ``But sometimes we don't find the answer by being smart or because of our experience _ we find it by persistence, by being a mule.''

In addition to solving medical mysteries, Gaffney's nine full-time general pediatricians care for patients other doctors admit to Children's Hospital.