Experience in the evaluation of children with hepatosplenomegaly at a teaching ambulatory, São Paulo, Brazil.

Autor:	Bricks LF; Departamento de Pediatria de Faculdade de Medicina da Universiade de São Paulo, Brasil., Cocozza AM, Resegue R, Sucupira AC, Rodrigues D, Kobinger ME, Bourroul ML, Zuccolotto SM, Bresolin AM
Jazyk:	angličtina
Zdroj:	Revista do Instituto de Medicina Tropical de Sao Paulo [Rev Inst Med Trop Sao Paulo] 1998 Sep-Oct; Vol. 40 (5), pp. 269-75.
DOI:	10.1590/s0036-46651998000500001
Abstrakt:	Objectives: Describe cases of children with hepatosplenomegaly (HS) attended at the General Pediatric Teaching Ambulatory (AGER) of Instituto da Criança, São Paulo, identifying the main causes, evolution, necessity for hospitalization and/or referral to specialists. Methodology: Retrospective analysis of the records of children presenting HS on admission at AGER from September 1, 1993 to August 31, 1996. Results: Of the 89 children included (age range, 1 to 148 months; 24 months), 64 (72%) were referred from other services for HS investigation. Most common presenting complaints were: fever--39 (44%); pallor--26 (29%); weight loss--21 (24%) and jaundice--14 (16%). Main alterations noticed on physical examination were: pallor--47 (53%) and short stature--17 (19%). Anemia was diagnosed in 70 children (79%); 35 children (39%) had infections; 7 (8%) metabolic disorders and 5 (6%) neoplastic disorders. The most frequent infections were of the urinary tract--9 (10%) and hepatitis A--6 (7%). Thirty six children (40%) were referred to specialists, 17 of which were already diagnosed. Conclusions: Most of the children with HS present deficiency anemia associated with infections which the general pediatrician is able to diagnose. Persistence of unexplained HS for more than 2 months, especially when there is substantial volume enlargement or alteration in the organs consistency, is an indication for referral to specialists.
Databáze:	MEDLINE
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