Question
Case Report: - A 6 years old boy born of non consanguineous marriage presented with anasarca and abdominal pain since 3 days. There was no oliguria, breathlessness, fever. Birth and immunization history were normal. He was on a full diet. There was history of pica and passing worms in stools. On examination, he was pale, had ascitis with generalized edema, hepatosplenomegaly with tachycardia and gallop rhythm. Investigations showed:
· Hemoglobin = 3.8 gm/dl
· WBC count = 16,700/cumm (45% polymorphs, 28% lymphocytes, 26% eosinophils)
· Platelet count = 3, 87,000/cumm. Reticulocyte count = Normal
· ESR = 20 mm at end of 1 hour
· Peripheral smear = Hypochromasia, microcytosis, anisocytosis, poikilocytosis. No parasites.
· Total proteins = 5.6 gm%, albumin = 3.1 gm%
· Serum calcium, phosphorus, alkaline phosphatase = Normal
· Urine = Normal
· S.creatinine, BUN, SGOT, SGPT = Normal
· Urine Albumin/creatinine = 0.39
· S. cholesterol = 65 mg%
· Ascitic tap = dry tap
· USG Abdomen: Hepatosplenomegaly with minimal fluid
· Urine culture: No growth
· HIV, Mantoux test: Negative.
· Chest X-Ray shows – Cardiomegaly with right paracardiac haziness.
Child was given blood transfusion and treated with frusemide, hematinics and deworming agents.