A patient with fever and focal seizure: herpes encephalitis.
Please remember, varicella causes generalized seizure and SSPE (subacute sclerosing panencephalitis) causes symmetric seizure activities.
How to adjust the dose of valproic acid in a child with seizure: Troph serum level seven days after the starting dose. The beginning dose is 10 mg/kg/day, then increase the doses by 5 -10 mg/kg/week until the usual dose of 30 -40 mg/kg/day.
A patient appears with Kawasaki disease and abdominal pain: Hydrops of the gallbladder.
Evans syndrome: a combination of autoimmune hemolytic anemia with immune thrombocytopenic purpura. Patients may develop chronic disease like SLE and have poor prognosis.
Glycogen storage disease type Ib and neutropenia: severe hepatomegaly and growth retardation are present; a defective neutrophil mobility and neutropenia can cause recurrent b acterial infections.
TREATMENT: antibiotic; rhG -CSF correct neutropenia.
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