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Posted On : 28 Sep 2025

The patient is a 5-year-old with cc of both feet dorsum edema, which started 3-4 months ago.p, E`mild splenomegaly. No fever.well nourished. Growth is normal.lab data.only moderate eosinophilia.mild microcytic anemia. Toxocara canis serology -ve. 2-month follow-up is normal. What is ddx, and what other investigations?

Expert Answer :

Answer Discussion :

M

mfon ufot

0

foot and hand syndrome, do hb electrophoresis

5 Days ago

D

Dfsa Ata

0

schistosoma or other parasite
other causes of mild splenomagaly without fever
renal function test

5 Days ago

S

Salum Ali

0

Helminthiasis, stool analysis

5 Days ago

N

Nariman Abedini

1

Filariasis

5 Days ago

M

Murali Reddy

1

hb electrophoresis, reticulocyte ct

5 Days ago

Answer 1

This child with the information available it is not possible to reach any definitive conclusion. He needs to be given a trial of Hetrazan and reviewed clinically and observed for the disappearance of dorsal oedema.
He needs observation for 1. persistence of eosinophilia, what happens to splenomegaly, development of any organ damage, especially the liver, heart, and CNS.
if there is no deterioration, eosinophilia resolves, oedema becomes less, leave him alone with continued observation.
In case there is persistence of eosinophilia, splenomegaly increases, systemic symptoms appear, look for end-organ involvement and consider doing 2D Echo for r, o enomyocardial fibroelastosis. If so, then do work up to r, o Myeloproliferative variant of eosinophilia or do flow cytometry to look for clonal lymphoid population to r, o lymphoproliferative variant of Eosinophilia. Maybe a BM with FISH for PDGFRa-FIP1L1 may be done if Myeloproliferative eosinophilia is considered.
Very often, these investigations may not be very rewarding

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