Differential Diagnosis for a 3-year-old Female Post Dental Surgery with New Onset Anasarca and Large Proteinuria
- Single Most Likely Diagnosis
- Nephrotic Syndrome: This condition is characterized by massive proteinuria, hypoalbuminemia, and edema (anasarca). It is a common cause of edema and proteinuria in children, and the onset can be triggered by various factors, including infections or, less commonly, reactions to medications that might be used in dental surgery.
- Other Likely Diagnoses
- Acute Kidney Injury (AKI): Post-surgical AKI can occur due to various factors such as hypovolemia, use of nephrotoxic medications, or sepsis. While AKI can cause edema and proteinuria, the proteinuria is typically not as massive as seen in nephrotic syndrome.
- Minimal Change Disease: This is a common cause of nephrotic syndrome in children, often presenting with sudden onset of massive proteinuria and edema. It's worth considering, especially if nephrotic syndrome is suspected.
- Do Not Miss Diagnoses
- Post-Streptococcal Glomerulonephritis (PSGN): Although less common, PSGN can occur after infections and is a significant cause of acute nephritic syndrome, which can sometimes present with edema and proteinuria. It's crucial to consider due to its potential for serious complications if not treated.
- Hemolytic Uremic Syndrome (HUS): This condition, often associated with E. coli infections, can lead to acute kidney injury, hemolytic anemia, and thrombocytopenia. While it typically presents with more systemic symptoms, it's a critical diagnosis not to miss due to its severity.
- Rare Diagnoses
- Congenital or Acquired Lymphatic Disorders: Conditions affecting the lymphatic system can lead to anasarca due to impaired lymphatic drainage. However, these are rare and would typically have other associated findings or a longer history of symptoms.
- Systemic Lupus Erythematosus (SLE): Although rare in young children, SLE can cause nephritis leading to proteinuria and edema. It's a diagnosis that requires consideration due to its complexity and the need for early intervention to prevent long-term damage.