Differential Diagnosis for 8y Female with Urinalysis Results

Single Most Likely Diagnosis

• Diabetic Ketoacidosis (DKA): The presence of ketones (ket 5+) and protein (pro 15+) in the urine, along with the patient's age and symptoms, suggests DKA as the most likely diagnosis. The pH of 6 also indicates acidosis, which is consistent with DKA.

Other Likely Diagnoses

• Urinary Tract Infection (UTI): Although the nitrite test is negative (nit-), the presence of protein (pro 15+) and leukocyte esterase (let 70+) could still indicate a UTI, especially if the patient is symptomatic.
• Nephrotic Syndrome: The significant proteinuria (pro 15+) could be indicative of nephrotic syndrome, although the absence of other supporting findings (e.g., low serum albumin, hyperlipidemia) makes this less likely.

Do Not Miss Diagnoses

• Sepsis: Although less likely, the presence of leukocyte esterase (let 70+) and protein (pro 15+) could indicate a severe infection, such as sepsis, which would be life-threatening if missed.
• Acute Kidney Injury: The significant proteinuria and hematuria (bil 1+) could indicate acute kidney injury, which requires prompt recognition and treatment to prevent long-term damage.

Rare Diagnoses

• Alport Syndrome: A rare genetic disorder characterized by hematuria, proteinuria, and progressive kidney disease. Although unlikely, it should be considered in the differential diagnosis, especially if there is a family history.
• Fabry Disease: A rare genetic disorder that can cause proteinuria, hematuria, and kidney disease. It is unlikely but should be considered in the differential diagnosis, especially if there are other systemic symptoms.