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| Pediatric Nephrology |
| (Discussion on 03 July 2005) |
| Principal Discussant |
: |
Dr VijayaKumar
Paediatric Nephrologist
Chennai |
| Time |
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11 am |
| Venue |
: |
Medserve/ CKC |
Case History
| Patient |
: |
13 year old girl |
| Complaints |
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Fever – 2 days duration
Vomiting – 5 days duration
Loose stools – 2 days duration
Cough & cold -2 days duration |
| Admission into hospital |
: |
07.06.2005 |
| Clinical findings on admission |
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Patient was conscious, running fever of 100°F, was dehydrated.
Blood pressure was 120/90 in both postures.
There was no other abnormal finding.
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| Course in hospital |
: |
Patient underwent peritoneal dialysis on 09.06.2005.
Patient’s urine output improved from 10/6/05 onwards.
Patient was discharged on 15.06.2005.
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Investigations
| Urine routine |
: |
Pale, yellow, clear acidic
Albumin – Nil
Sugar - Nil
Pus cells – uncentrifuged – nil
Centrifuged - 6 to 8
RBCs 1-2
Epith. Cells 2-3 |
Blood:
| Test |
07/6 |
08/6 |
09/6 |
10/6 |
11/6 |
12/6 |
13/6 |
14/6 |
15/6 |
18/6 |
| Urea |
88 |
96 |
122 |
72 |
56 |
66 |
86 |
71 |
59 |
28 |
| Creatinine |
7.0 |
7.9 |
8.8 |
7.4 |
6.2 |
5.5 |
6.6 |
2.9 |
2.0 |
1.2 |
| Potassium |
4.8 |
4.8 |
3.8 |
3.7 |
3.1 |
4.2 |
4.3 |
4.2 |
4.1 |
4.1 |
| Sugar |
73 |
- |
145 |
131 |
157 |
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| Sodium |
142 |
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| Chloride |
102 |
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| Hb |
10.7 |
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| Differential count |
P 72
L 18
M 8
E 2 |
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| Total protein |
6.1 |
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| Albumin |
3.5 |
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| Calcium |
9.4 |
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| Phosphorous |
2.3 |
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| Bilirubin |
0.6 |
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| SGPT |
12 |
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| Uric acid |
9.8 |
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| BT |
3 mts |
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| CT |
6 mts |
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| PT/Control |
13/12 |
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| PTT/Control |
30/29 |
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| Platelet count |
2,56,000 |
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| LDH |
343 |
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| Smear for Malarial Parasites |
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negative |
| Smear for Schistocytes |
: |
negative |
| Peripheral smear |
: |
Mild normocytic to microcytic, normochromic anaemia
with relative neutrophilia and normal platelets. No abnormal
cells or haemoparasites seen. |
| Ultrasound abdomen |
: |
Right kidney 10.0 x 4.9 cms.
Left kidney 9.8 x 4.7 cms.
Echoes minimally increased.
Collecting system not dilated.
No calculus.
Liver : Normal
Gall bladder : Contracted. Walls are thickened.
Contains microcalculi.
Spleen, Pancreas, Urinary bladder - Normal
Impression:
- Micro calculi in gall bladder
- Normal sized kidneys with minimal increase in parenchymal echoes with prominent renal pyramids.
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