| QUIZ: Oedemas after camp *solved* |
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| Wednesday, 09 December 2009 19:57 |
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Case description: 9 yo girl came with her mother to a GP. The girl has been having oedemas on her eyelids for a few days. Mother claims that the daughter returned from a school camp about a week ago. Children were sleeping in tents and most of the time spent on meadows and in the forrest. Physician suspected some kind of allergic reaction so he directed the girl to an allergy outpatient clinic. Quizz questions: You are allergologist who sees this girl. What are your suspicions? What tests do you order? |
Comments
physical examination.
Tests which I would do: CBC, creatinine, total proteins, electrolytes, general urine tests. Allergy tests: skin tests.
In physical examination the oedemas are the only disorder.
Skin tests: Timotheusgras 5/6
In the lab test which you wanted the only disorder is proteinuria.
It's very possible for children in her age that it is a submicroscopic glomerulonephri tis.
Abdomen ultrasonography (kidneys especially) and we need to think about biopsy (it's best to see it under an electron microscope)
I've added this case to show that face oedemas, even in characteristic situations, don't need to be caused by allergies and we need to remember about risky kidney diseases.
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