4th Pediatric Infectious Diseases Conference
 
 
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Specialist Answers
Question
Sending here with a case history. Kindly comment on differential diagnosis and management. A 11 year old female, whose parents had a non-consanguious marriage( rajsthani ) presented with c/o-abdominal pain since 20 days. She was tired on walking or accustomed work but no dyspnoea. Vomiting was once every 2nd or 3rd day, nonprojectile, no relation to food. mild fever occurs daily but resolves after antibiotics. All comp since 20 days. Father also noticed yellowness of eyes since 20 days. All come more or less at same time . Baby was admitted to a hospital 10 days before. 2 blood transfusions 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 hospitalization and transfusion 6 month back given 2 transfusion at that time in between absolutely symptom free. please guide about d/d and diagnostic approach.
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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