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738-B Puliakulam Road
Near Lakshmi Mills
Coimbatore 641 045
Tamil Nadu
India
Pediatric Nephrology
(Discussion on 03 July 2005)
Principal Discussant : Dr VijayaKumar
Paediatric Nephrologist
Chennai
Time : 11 am
Venue : Medserve/ CKC

Case History

Patient : 13 year old girl
Complaints : 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 :

Patient was conscious, running fever of 100°F, was dehydrated.
Blood pressure was 120/90 in both postures.
There was no other abnormal finding.

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.

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          
Sodium 142                  
Chloride 102                  
Hb 10.7                  
Differential count P  72
L  18
M  8
E  2
                 
Total protein 6.1                  
Albumin 3.5                  
Calcium 9.4                  
Phosphorous 2.3                  
Bilirubin 0.6                  
SGPT 12                  
Uric acid 9.8                  
BT 3 mts                  
CT 6 mts                  
PT/Control 13/12                  
PTT/Control 30/29                  
Platelet count 2,56,000                  
LDH 343                  

Smear for Malarial Parasites :

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:

  1. Micro calculi in gall bladder
  2. Normal sized kidneys with minimal increase in parenchymal echoes with prominent renal pyramids.

 

Click here to print the case history (PDF file)

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