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Question |
sending herrewith case history. kindly comment on differential diagnosis and management. 11 year female. parent non-consanguious marriage. rajsthani presented with c/o-abdominal pain since 20 days,tired on walking or accustomed work but no dyspnoea.vomiting -once every 2nd or 3rd day nonprojectile no relation to food.mild fever daily resolves after antibiotics.all comp since 20 days . father also noticed yellowness of eyes since 20 days. all comp more or less at same time . baby admitted to a hospital 10 days before. 2 blood transfusion were given. O/E-pallor++ icterus++ vital stable , hepatomegaly 8cm firm regular surface, well defined edge, splenomegaly 5cm along axis, notch not felt soft, previous h/o of exactly similar c/o hospitalisation and transfusion 6 month back given 2transfusion at that time in between absolutely symptomfree . please guide aboutr d/d and diagnostic approach
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Answer |
Rule out chronic liver disease, malignancy and HIV. Do complete LFT, USG Abdomen, CBC with retic count, peripheral smear. If retic count is low and anemic, a bone marrow may be required.
If USG suggestive of portal hypertension, an OGD scopy may be required
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