Question of the Week

Question :
Posted On : 31 Oct 2008
A 12 year old hiv positive female presented with progressive abdominal distention since a year and severe short stature. No history suggestive of cns, cvs or hematological system involvement. There was admission for 7 days at 6 yrs of age for fever {details not available}. Father died of kochs 5 yrs back. Mother died postpartum- cause not known. Younger sib also expired. Paient is severely short statured with height age-6yrs and weight 17 kg. She has huge {17cm} spleen. Left lobe liver is palpable 5 cms in mid sternal line. Hemoglobin is 6, peripheral smear-hypo micro, wbc and platelet-wnl. Bili 1.3. Bone age more than 12yrs. Osteopenia on X-ray. what working diagnosis to keep in this case? How to investigate further?
5
Expert Answer :
No expert answer available.
Answer Discussion :
S
sombat ratchata
Profile
blood for hemoculture, Calcium, Phosphate, calcitriol, parathyroid hormone,CD4, abdominal ultrasonography,
stool for AFB, chest x-ray, tuberculin skin test, sputum for AFB x 3days,

16 years ago
S
Sabri Sakrana
Profile
further investigations have to be done, Hb.electrophoresis, Kidney Functiion tests,S.Proteins, CXR, infection screen
16 years ago
A
Amber Fatima
Profile
lymphoma
16 years ago
D
Doctor. Hany
Profile
Hb electroporesis to rule out SCA
16 years ago
P
pediatriconcall
Profile
HIV itself can lead to short stature and delayed puberty due to malnutrition, growth hormone deficiency and thyroid dysfunction and also due to other opportunistic infections. Rule out other co-infections such as Hepatitis B and C. Also rule out liver disease and portal hypertension. Get her CD4 counts done and if low start on ART provided infection is ruled out.
16 years ago




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