Approach to practical pediatrics 2nd edition pdf free pdf. He was the 6pound, 7 ounce product of an uncomplicated 37 week gestation to a 38yearold g2p2 female. In a seriously ill child with evidence of significant bleeding, such as lethargy, pallor, diaphoresis, dizziness or orthostatic changes in heart rate or blood pressure, immediate attention is given to stabilizing the child after a quick focused history. A unique clinical algorithm devised by dr ira shah, consultant pediatrician and co incharge pediatric. Further relevant information on causes of hepatosplenomegaly may be found in. Viral hepatitis jaundice, hepatosplenomegaly, lymphadenopathy, wasting, cachexia, ascites, asterixis, caput medusa. Abdominal pain in a child is one of the most common presentations with both trivial and lifethreatening etiologies, ranging from functional pain to acute appendicitis. Apr 14, 2009 a 46yearold woman was hospitalized due to fever of up to 39c of one weeks duration.
It is important to realize that the liver is easily palpated in most children at 12 cm below the right costal margin. Montreal childrens hospitalmcgill university health centre. Hepatosplenomegaly in pediatrics by sami aswad on prezi. Hepatosplenomegaly symptoms, diagnosis, treatments and. Kupffer cell hyperplasia with tb or other generalized infections 3. In the past, splenomegaly was a clinical finding, but in recent years, imaging studies have also helped to assess for or confirm mild splenomegaly. Hepatosplenomegaly can occur as the result of acute viral hepatitis, infectious mononucleosis, and histoplasmosis or it can be the sign of a serious and lifethreatening lysosomal storage disease. Related information on causes of hepatosplenomegaly.
This caucasian newborn boy was transferred for evaluation of hepatosplenomegaly. They are referred to you because they are planning on having their first child and nafia has heard thalassemia is present in her family. The child with hystiocytosis presented marked pallor, fever, anemia and thrombocytopenia, besides hepatosplenomegaly, dermatitis and a poor general condition that suggested this diagnosis 16. Definitive diagnosis is established by performing relevant investigations. The following medical news items are relevant to causes of hepatosplenomegaly. Approach to hepatomegaly, splenomegaly and hepatosplenomegaly free download as powerpoint presentation. Approach to practical pediatrics 2nd edition pdf free download you can score 75% marks by reading just 25% but the question is which 25%. Hepatomegaly splenomegaly hepatosplenomegaly to be evaluated based on the history and associated physical findings to arrive at a reasonably good clinical diagnosis. List the important diagnostic considerations in patients who have hepatomegaly.
The patient had no past medical history, and did not take any medications, supplements, or illicit drugs. Approach to a child with hepatosplenomegaly summary of pathophysiological mechanisms 1. In glucogen storage disease type 1b, neutropenia and neutrophil dysfunction are present in contrast to the other types. Approach to hereditary storage diseases in patients with. Approach to hereditary storage diseases in patients with hepatosplenomegaly.
The spleen is a functionally diverse organ with active roles in immunosurveillance and hematopoiesis. More news related information on causes of hepatosplenomegaly. Approach to a child with hepatosplenomegaly slideshare. Approach to hepatomegaly, splenomegaly and hepatosplenomegaly. Approach to a child with hepatosplenomegaly powerpoint presentation. Nov 14, 2012 approach to a child with hepatosplenomegaly 1. We present the case of a 5monthold girl who had fever, hepatosplenomegaly, and hematologic abnormalities at the initial examination. Sunil agrawal1st year md residentdepartment of child health 2. Sunil agrawal1st year md residentdepartment of child health. In glucogen storage disease, hypoglycemia, convulsions and hepatosplenomegaly are observed in relation with disruption in glucose6phosphate translocase enzyme. Hepatomegaly in neonates and children american academy of.
Christopher cheung approach to pediatric abdominal. Pediatric annals anemia is a pervasive problem in pediatrics and evaluating for it is considered part of standard care for all pediatric patients. To understand approach to a bleeding child, it is essential to know the steps in hemostasis. In glucogen storage disease type 1b, neutropenia and neutrophil dysfunction are present in.
Department of hematologyoncology, massachusetts general hospital, boston, mass after completing this article, readers should be able to. Hepatomegaly is enlargement of the liver beyond its normal size and occurs mainly as a consequence of pathologic conditions. Children who have orthopedic abnormalities such as narrow chest walls or pectus excavatum can erroneously appear to have hepatomegaly. There are few articles in the literature reporting the experience of general pediatricians in the approach to children with hepatomegaly andor splenomegaly hs. Discuss the differential diagnosis of localized and generalized. It is a reservoir for platelets and a site for the proliferation of blymphocytes. Jan 09, 2015 approach to a child with hepatosplenomegaly slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. In this paper, the aim is to give an overview of how to deal with these patients clinically to establish a. Prolonged fever, hepatosplenomegaly, and pancytopenia in a 46. When evaluating a child with splenomegaly it is important to identify conditions in which immediate medical intervention is needed and provide appropriate treatment options. In most cases, a systematic approach based on tripod of clear history, careful clinical examination with the special attention to the types and other characteristics of rash. There are more than 150 different disorders which have been described till date.
Christopher cheung approach to pediatric abdominal pain. Lavine, md, phd objectives after completing this article, readers should be able to. Thus, the challenge for the general pediatrician is to learn how to distinguish pathologic from nonpathologic lymph nodes and to develop a rational approach to the evaluation of lymphadenopathy. When evaluating a child with hepatomegaly it is very important to identify conditions in which immediate medication intervention is needed and provide appropriate treatment options. Overview introduction hepatosplenomegaly hepatomegaly splenomegaly causes hepatosplenomegaly hepatosplenomegaly history physical examination investigations and treatment approach in children and neonate summary. Develop a systematic approach to the evaluation and management of lymphadenopathy. The clinical approach depends upon the age of presentation, site of involvement in brain. Approach to the patient with neutropenia in childhood. It is with the concept of finding this 25% that this book was written.
Splenomegaly is defined as enlargement of the spleen, measured by size or weight. Hepatosplenomegaly pancytopenia, bone pain, seizure, osteoporosis enzyme testing for glucocerebrosidase. Other functions include filtering senescent and defective red blood cells, presenting antigens to the immune. Hepatosplenomegaly commonly abbreviated hsm is the simultaneous enlargement of both the liver hepatomegaly and the spleen splenomegaly. Childhood rashes are cutaneous eruptions of acute onset. Started in 1995, this collection now contains 6767 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. Hepatosplenomegaly information including symptoms, diagnosis, misdiagnosis, treatment, causes, patient stories, videos, forums, prevention, and prognosis. An approach to a child with regression of milestones authorstream presentation. Fever, hepatosplenomegaly, and pancytopenia in a 5monthold. She was born and lived all her life in a rural village.
Approach to a child with hepatosplenomegaly slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Approach to a child with hepatosplenomegaly xpowerpoint. May 19, 2018 hepatosplenomegaly refers to an enlargement of the liver and spleen. Clinically they may be categorized as maculopapular, pustular, vesiculobullous, diffuseerythematous, or petechialpurpuric in nature. Hepatosplenomegaly in an infant who has no hyperbilirubinemia suggests an obstructive or infiltrative cause. Hepatosplenomegaly with fever can be due to acute leukemia, non hodgkins l ymphoma.
Contains mostly myelinated axons appears pinkish white to the naked eye myelin is composed largely of lipid tissue veined with capillaries a 20 yearold male has a 176,000 km of myelinated axons in his brain while that of a female is 149,000 km connect various grey matter areas the locations of. Common causes of hepatosplenomegaly in children can be summarized as follows. Aug 01, 2001 evaluating the child with purpura this is a corrected version of the article that appeared in print. The majority of pediatric abdominal complaints are relatively benign e.
Abdominal pain in a child is one of the most common presentations with both trivial and life. Hepatosplenomegaly hpm is a disorder where both the liver and spleen swell beyond their normal size, due to one of a number of causes. Hepatomegaly general presentation hepatomegaly can represent intrinsic liver disease or may be the presenting physical finding of a generalized disorder. Hepatomegaly can represent intrinsic liver disease or may be the presenting physical finding of a generalized disorder. Pushpa raj sharma professor of child health institute of medicine case history eight months, male, from. Evaluating the child with purpura this is a corrected version of the article that appeared in print. Its causes include a variety of conditions that affect these two organs, including liver disease, hiv, anemia, infections, and. A normal variant of the right lobe of the liver, called a riedel lobe, may extend far below the right costal margin and be confused as pathologic hepatic enlargement. Approach to a child with hepatosplenomegaly 1 free download as powerpoint presentation. Identify the possible causes of simultaneous hepatomegaly and splenomegaly.
Fever, hepatosplenomegaly, and pancytopenia in a 5month. This topic will provide guidelines for our approach to the evaluation of peripheral lymphadenopathy in children. Diagnostic approach to primary immunodeficiency disorders. Hepatomegaly in neonates and children american academy. Prolonged fever, hepatosplenomegaly, and pancytopenia in a. The guidelines are intended to supplement clinical judgment in the absence of research that directly addresses how children with unexplained lymphadenopathy should be evaluated. Evaluating the child with purpura american family physician. Evaluation of rash in children approach bmj best practice.
Child with a sore ear otalgia to vaccinate or not to vaccinate. Approach to a child with hepatosplenomegaly 1 liver public. Sep 01, 2015 in glucogen storage disease, hypoglycemia, convulsions and hepatosplenomegaly are observed in relation with disruption in glucose6phosphate translocase enzyme. Evaluation and management of lymphadenopathy in children. Because of its association with malignancy, lymphadenopathy can be a major source of parental anxiety. Sep 19, 2017 hepatosplenomegaly hpm is a disorder where both the liver and spleen swell beyond their normal size, due to one of a number of causes.
Hepatosplenomegaly refers to an enlargement of the liver and spleen. When evaluating a child with a potential bleeding disorder, it is extremely crucial to ascertain whether the patients symptoms are appropriate to a bleeding disorder and whether further investigation of an underlying bleeding disorder is required. Histiocytosis is a rare disorder of histiocytic proliferation, with variable and often unpredictable behavior. Vimsupdates 6aprilnew iap ug teacing module 2016backup. As with all medical conditions, there may be many causal factors. Diagnostic approach to primary immunodeficiency disorders m m adkaikar, am ishra and k g hosh from department of pediatric immunology and leukocyte biology, national institute of immunohaematology icmr, th floor, nms bldg, kem hospital, parel.
Splenomegaly general presentation the spleen is a hematopoietic organ supporting the megakaryotic, lymphoid, erythroid, myeloid, and reticuloendothelial systems. A normal liver should feel soft and is easily moveable upon inspiration. The name of this condition hepatosplenomegaly comes. However, in many etiologies these forms may coexist. Kupffer cell hyperplasia with tb or other generalized infections. Hepatosplenomegaly in a young child can be an ominous physical finding, potentially representing a metabolic, malignant, or infectious process. Contains mostly myelinated axons appears pinkish white to the naked eye myelin is composed largely of lipid tissue veined with capillaries a 20 yearold male has a 176,000 km of myelinated axons in his brain while that of a female is 149,000 km connect. Many inherited metabolic disorders present with neural regression. An approach to a child with regression of milestones. Early diagnosis and treatment of children who have liver disease is important because specific treatments are available for some diseases that can prevent disease progression or hepatic failure. Approach to a bleeding child pediatric oncall journal. If you continue browsing the site, you agree to the use of cookies on this website. The patient complained of weakness, night sweats, and weight loss for two weeks prior to admission.