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A 5 year old patient presents with her parent to the ER department with increasing eye and leg edema.  The parent is also concerned by the child's poor growth.  The patient is a poor feeder with normal urine output.  Upon physical examination the patient appears unwell and tired and has a gallop rhythm. The liver appears 2cm below the costal margin.  Labwork is as follows: 

Urinalysis: negative protein and blood

Serum albumin: 34 g/L

Serum creatinine: 26 umol/L

What is the most likely etiology of this child's edema?

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Authors

Dr. Gabriele Weiler

gweiler@cheo.on.ca

Dr. Joanna Holland

joanna.holland@iwk.nshealth.ca

Dr. Joanne Grimmer

joanne.grimmer@lhsc.on.ca

Reviewers

Dr. Karen Grewal

grewalk@kgh.kari.net

Queen's University

Dr. Theresa Wu

theresa.wu@ahs.ca