Puffy

A 5-year-old boy presents with a severe headache since waking up today. In the preceding 4 days, he experienced abdominal discomfort and swelling of his face and both legs.

His medical and family histories are unremarkable, his growth and development are age appropriate, and all immunizations are up to date. He is on a normal adult diet, and is the only child of non-consanguineous parents.

His full blood count, renal functions, and serum electrolytes are all within normal parameters. However, the urinalysis is significant for 3+ proteinuria.

Select Relevant Investigations
Serum Albumin

Performed

Serum Albumin: 1.8 g/dL (3.5-5.0)
MRI + MR venography

Performed

There is a diffuse intraluminal thrombus within the superior sagittal sinus, and filling defects caused by thrombi within both transverse sinuses. No infarcts or hemorrhages are noted.
Serum C3 + C4

Performed

Serum C3 and C4 levels are within normal parameters.
ANA

Performed

The Antinuclear Antibody (ANA) assay is negative

Select Relevant Management
Corticosteroids
Systemic Thrombolytics
Low Sodium Diet
Furosemide