4yr old boy Weight 14kg

Generalized body swelling History Since 2 yrs he having dis prblm.. Some time subside.. Vitals Normal Investigations LFT Urine Routine and microscopic Diagnosis Nephrotic Syndrome ? Management What is d Dx and Rc

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Child of 4 years , Nephrotic syndrome is common. Usually it is minimal lesion nephrotic syndrome. Massive proteinuria, causes low serum protein ,hypoalbuminemia and albumin: globulin ratio reversal. In this case there is hypoproteinemia, hypalbuminenia, and low globulin also and absence albumin: globulin ratio reversal. Needs further investigation to clarify. Unusually, in this case , there are also changes in hepatic enzymes and ALP rise . Need to do Renal function tests, protein electrophoresis , lipid profile, tests for hypercoagulability state, and renal biopsy. Minimal lesion nephrotic syndrome responds well to albumin infusions, and oral prednisone. Steroid resistant NS may require immunosuppressive drugs

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Gross albuminurea Hypoproteinemia A/G ratio is reversed Pus cells in urine are 22 to25 Suggest chr glomerulo nephritis Yes likely nephrotic syndrome But you have not mentioned the clinical picture Usg /ct abdomen needed to look for nephrotic syndrome Rx diuretic Steroids in loading doses Antibiotics as per urine for c&s

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24 hour urinary protien is the gold standard investigation.. Though decreased serum albumin,+++ urinary protein levels more suggestive of neprotic syndrome.. Moreover UTI needs to be treated

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Nephrotic synd..?? Syp-prednisolone.. 5 ml.. Bd for 4 weeks After that small dosage for 4 weeks..

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May be. Adv. RFT R/O Autoimmune disease

Nephrotic syndrom

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