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Approach To A Child With Hepatosplenomegaly
Approach To A Child With Hepatosplenomegaly
With
Hepatosplenomegaly
Dr. Pushpa Raj Sharma
Professor of Child Health
Institute of Medicine
Case History
Eight months, male, from Rupandehi.
Fever with cough and difficulty breathing for
History contd.
Uneventful perinatal period.
Exclusive breast feeding for 3 months.
Repeated treatment with antibiotics since
Examination
Wt: 5 Kgs; Length: 64 cms; OFC: 39.5 cm
Apyrexial; R/R: 66/min; P/R: 150/min.
No pallor; no lymphadenopathy; no rash; no
Investigations
Hb: 12.2.g/dL; TLC/DLC: normal; ESR: 20mm/hr.
Hepatosplenomegaly: Causes
Infective:
Viral:
Hepatosplenomegaly: Causes
Haemopoetic:
Metabolic:
Hepatosplenomegaly: Causes
Malignancies:
Immunological:
Developmental:
Congestive:
This patient
Infective cause that can have lung, liver and
spleen involvement:
Sepsis/other bacterial infection unlikely: normal
blood count, normal immunological reports for
HIV, TORCH, syphilis.
Viral infections unlikely: normal liver function test,
no clinical evidence of congenital infections as:
This patient
Protozoal unlikely:
Haematological unlikely:
Malignancies unlikely:
This patient
Immunological unlikely:
Developmental unlikely:
Congestive unlikely:
This patient:
Metabolic Diseases Causing Hepatosplenomegaly
Infantile GM1 gangliodidosis (type 1)
Hepatosplenomegaly at birth, oedema, skin
erruptions, retardation development, seizure
Gauchers:
Fucosidosis:
Macroglossia, neurodegenerative features
Wolman disease:
This patient
Neiman-Pick disease :