Clinical History.—This 5-year-old girl developed mild conjunctivitis when returning from a trip to Mexico, one month prior to hospitalization. One week later, periorbital edema was noted, which also resolved after one week. Four days prior to hospitalization, she was noted to have increased in abdominal girth and the size of her upper thighs, and a weight gain of 1.8 to 2.2 kg. No other family member was ill.
Physical Examination.—The patient was afebrile, not icteric, and in no distress. Her abdomen was distended, and shifting dullness was present on percussion. Slight pitting edema was noted over the sacrum, the lower abdomen, and the upper thighs, but not peripherally. No organomegaly was detected. Results of the physical examination were otherwise entirely normal.
Results of urinalysis were normal with no proteinuria. Hemoglobin value was 14.5 gm/100 ml with a hematocrit reading of 45.0%. White blood cell count was 11,400/cu mm