Differential Diagnosis for 7-year-old with Vomiting, UA Positive for Protein, and SG 1.005
- Single most likely diagnosis:
- Acute gastroenteritis: This is a common condition in children, often presenting with vomiting. The presence of protein in the urine (proteinuria) could be transient due to dehydration or vomiting, and a specific gravity (SG) of 1.005 indicates diluted urine, which might be seen in the context of increased fluid intake or vomiting.
- Other Likely diagnoses:
- Dehydration: Although dehydration itself is not a diagnosis, it's a likely condition given the symptoms. The diluted urine could indicate an attempt by the body to conserve water, and vomiting would exacerbate dehydration.
- Urinary tract infection (UTI): UTIs can cause vomiting and proteinuria. However, the SG of 1.005 might not directly correlate with a typical UTI presentation unless the child is also dehydrated.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Diabetic ketoacidosis (DKA): Although less common, DKA can present with vomiting and would be a critical diagnosis not to miss. Proteinuria can occur, and the SG of urine might be variable depending on the hydration status and the presence of ketones.
- Acute kidney injury (AKI): This could be a consequence of severe dehydration or another underlying condition. AKI would explain the proteinuria and potentially the SG of the urine, depending on the kidney's ability to concentrate urine.
- Rare diagnoses:
- Nephrotic syndrome: This condition is characterized by significant proteinuria, but it's less likely given the acute presentation with vomiting. However, it's a diagnosis that would need consideration if proteinuria persists.
- Other renal diseases (e.g., acute glomerulonephritis): These conditions could present with proteinuria and potentially vomiting if associated with significant dehydration or electrolyte imbalances. They are less common but important to consider in the differential diagnosis.