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Case (1)


Mohamed  Ali is a four-year-old boy who is referred to hospital by his family doctor.
He has presented with generalized
edema and is found to have heavy proteinuria (4.1g/l) & hypoalbuminaemia. A renal biopsy shows no abnormality on routine light microscopy
1 What syndrome has this child presented with?

2 What is the probable diagnosis?

3 What further investigation may be helpful and what would confirm your diagnosis?

4 Is this condition treatable, if so how and  what is the prognosis?
Who answer all these above questions correctly will be a warded 15 points immediately and we only accept one answer from each user?
who replies more than once will be kicked out from this competition!
The answers will be displayed after 7 days then we choose the winner and lock the topic
By: Dr.Mahdi  8)

the syndrome this child is presented with is Nephrotic syndrome
the probably diagnosis is Minimal change disease of children (also called lipoid nephrosis) which is not dangerous and respond to corticosteroids.
the investigations would include: GUE: profound proteinuria, and oval fat bodies; CBC: Hct and Hb high, random albumin to creatinine ratio high, low albumin, high lipid and cholesterol; urine specific gravity; all will confirm the diagnosis of nephrotic syndrome.
it has a good prognosis since it responds to corticosteroids, also diuretics, immunosupressents, immunomodulators, antineoplastic agents, and antibiotics are used to prevent complications that are some times fatal (like relapses and chronic renal failure, the two complications are also rare).

The 15 points goes to Dr.Ciise Dheere because he gave the correct answer, second he is the only one who replied the thread!
thanks Dr.Ciise Dheere and well done!!
1 Syndrome:

Nephrotic syndrome (proteinuria, oedema, hypoalbuminaemia)

2 Diagnosis:

In this age group, minimal change glomerulonephritis is by far the most likely diagnosis. Less common would be focal glomerulosclerosis, membranoproliferative glomerulonephritis, and proliferative glomerulonephritis.

3 Confirming diagnosis:

Light microscopy is usually normal, but electron microscopy frequently shows morphological abnormalities of the epithelial cells. Either fusion of the foot processes occurs (podocytes) or withdrawal of the foot processes so
that the epithelial cell body is sitting directly on the glomerular basement membrane.

4 Treatment and prognosis:

The condition normally responds over a period of weeks to treatment with corticosteroids; the long term outlook is excellent.
By: Dr.Mahdi


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