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June 1994

Pathological Cases of the MonthCase 1

Author Affiliations

From the Children's Hospital, New Orleans, La.

Arch Pediatr Adolesc Med. 1994;148(6):611-612. doi:10.1001/archpedi.1994.02170060065012

A 22-MONTH-OLD BOY presented with generalized swelling of his body. He was apparently in good health until 2 days prior to admission when he became febrile (temperature, 40°C) and had facial puffiness and swelling of the hands and feet followed by periorbital edema and a decreased appetite. There was no history of vomiting, diarrhea, dysuria, hematuria, dyspnea, jaundice, or respiratory illness. A 72-hour dietary history obtained by recall was used to estimate his average daily intake, which was more than 420 kJ/kg per day and 3 g/kg per day of protein. On admission, his weight and height were 11.5 kg and 91.6 cm, respectively. He was afebrile and had stable vital signs. Results of the physical examination were remarkable only for the presence of periorbital swelling, ascites, and pretibial, presacral, and pedal edema. He did not have a cardiac murmur or gallop rhythm on auscultation. There was good air exchange,

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