History
Freddie is a 3-year-old boy who presents to the paediatric clinic with a 2-day history of puffy eyes. His GP initially prescribed antihistamines but these have not helped. He is otherwise well. He has asthma, which is treated with budesonide 100 µg b.d. and salbutamol two to six puffs 4-hourly as necessary. He is on no other medication. His mother suffers from asthma and hay fever.
Examination
He looks well and is apyrexial. He has puffy eyes and pitting pedal oedema. Pulse is 112 beats/min, blood pressure is 103/70 mmHg and capillary refill is 2 s. There is no abdominal distension, tenderness or organomegaly. However, his scrotum appears oedematous. Respiratory rate is 28 breaths/min and there are no respiratory signs.
Questions
• What is the diagnosis?
• What other investigations should to be performed at presentation?
• What is the treatment?
• What are the complications of this condition?