User Name Password Remember Me  
 
 
   
Video Podcast
Audio Cast
Mobile(WAP)
  Pedi Poll  
Are adverse events during clinical trials being underreported?
Yes
No
  Translate This Page  
 
SPECIALIST ANSWERS

Question

13 year old girl presented with complantis of facial puffiness-3wks,abdominal distension for 2wks,weakness and body pain lasting for 6-7 months. there is no history of hematuria or polyuria. there is no h/o breathlesness,chestpain,cough. there is no h/o jaundice,bleeding manifestations,abdominal pain,diarrhoea,vomitting. there is no h/o tuberculosis in past. o/e there is severe pallor,nolymphadenopathy,no icteruus,anasarca. there is tense ascites and no other significant findings. investigations revealed: hb 5gm% tc 12800 dc p 35 l65 e0 m0 esr 70 mm urine alb ++++ pus full field rbc abs casts abs se.sugar(r) 87 mg% se.bili T 0.9 mg% D 0.2 mg% AST 34 IU/L ALT 35 IU/L ALK PHOS 133 IU/L S.PROTEIN total 2.0 gm% alb 0.8 gm% urine culture was sterlie. blood culture was sterile. perip.smear showed rbc microcytic,hypochromic,target cells. wbc lymphocytosis. platelets 1.7 lakhs/ retic count 17% SICKLING TEST was positive. USG ABDOMEN reveals normal liver texture,gross ascites and renal parenchyma disease grade 1.ovaries normal. chest XRAY shows b/l pleural effusion and pericardial effusion. pt was started with antibiotis and oral prednisolone. fresh FFP was transfused for 7 days. BT was given for 3 units. even after 3 weeks of steroid urine alb remains ++++ and ascites remained same. diagnostic tap revealed. prot. 0.3 gm% glucose 40 mg% cells 5,800/mm3 lymphocytes 100% A D A 1.4 u/L repeated urine cultures sterile. PUS cells remains full field. HIV SCREENING neg. RESPECTED SENIORS, i just want to have your advice reg. how to procede with the case. there are features of haemolytic anemia(SICKLE CELL),nephrotic syndrome and sterile pyuria. can we proceed with starting ATT drugs or go for UROGRAMS OR GO FOR RENAL BIOPSY TO FIND OUT RENAL PATHOLOGY. yours sincerely, a junior resident in pedia.

Answer

What are the serum creatinine and BUN? Also has hemolytic uremic syndrome been ruled out. The ascitic tap is suggestive of inflammation. Do a cytospin for malignant cells. For positive sickling test, do HbEPP to rule out sickle cell anemia. Since the child has been transfused, the HbePP cannot be done at the present and one may need to do parents HbEPP to see if they have the thal trait.
  Grants  
 » Apply For Research Grant
  Search  
Hospitals
Pediatrician
Special Schools
Medical Colleges
Pediatric Residency
Pediatric Conferences
Jobs & Vacancies
Journals
NGO's
  Ped Tools  
Pediatric Calculator
Drug Index
Medical Equipment
Vaccine Reminder
Adverse Drug Reactions
Biochemical Profile
Online MCQ's
  Calculators  
+ Growth
+ Conversion
+ Renal
+ Pregnancy
+ Blood Pressure
+ Blood Group
+ Critical Care
+ Drug Dose
+ Diarrhea Solution
+ Reference Values
+ Antibody Test
+ Drug Interaction
 
 
Parent Corner l Kids Corner l Terms & Condition | Privacy Statement l Advertising l Feedback l Awards
About Us
l Link to Us l Site Map l Shopping Mall  
Partner Sites
 HIV in Children  Infection in Children  Pedcall  Medical ADRIS  Vaccine Reminder  Pediatric Oncall Journal

Copyright© 2000-2008 All rights reserved with Pediatric Oncall

Disclaimer:The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitue an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.

 
Sitemap For Doctor | Sitemap For Parent | Sitemap For Kids Site designed and maintained by Levioza