Pediatric emergency medicine trisk 2937 2937

Symptoms and
signs

Laboratory

Treatment a

Fever

Malaise

Prednisone 1–2
mg/kg/day

Infection

CBC, urinalysis,
ESR, anti-DNA
antibodies
CH50 , C3
Cultures (blood,
urine, CSF, stool
and appropriate
secretions)
Chest radiograph
Gallium scan
Same as above

Fever, headache,
seizure, cough,
sputum, skin

lesions, arthritis,
disease flare,
weight loss
Dehydration, fever, Urinalysis, urine
weight gain,
culture, 24-hr urine
hypertension,
protein
decreased urine Serum creatinine
output
Creatinine clearance
Anti-DNA CH50 , C3,
C4
CBC, ESR, platelets
Electrolytes, BUN
Fatigue, malaise,
CBC, Coombs’,
pallor, dyspnea,
reticulocyte count,
edema
haptoglobin
Peripheral smear
Total bilirubin

Renal disease

Hemolytic
anemia

Central

Seizures, coma,

EEG, MRI, CT scan

Intravenous antibiotics
(broad spectrum)
Reevaluate prednisone
dose

Prednisone “pulse
therapy” (as needed)
Cytotoxic agents
(azathioprine PO or
cyclophosphamide
IV)
Plasmapheresis
Immunosuppressive
agents
Prednisone 2
mg/kg/day
Transfusion, if acute
emergency (may
need consultation
with transfusion
specialist to avoid
acute hemolysis of
transfused blood
products)
ICU admission