Freddie is a 3 year_old who presented to the paediatric rapid referral clinic whith a 2 day history of puffy eyes . His GP initially prescribed antihistamines but these have not helped . he is otherwise will .he has asthma ,which is treated with budesonide 100 ug b.d. and salbutamol two to six puffs 4_ hourly as needed . He is on no other medication . His mother suffers from asthma .
Examination::
He looks well and is apyrexial. He has puffy eyes and pitting pedal oedema. pulse is 112 beats\min.
Bp.is 103 \70 mmHg and capillary refill is 2s. There is no abdomenal distention , tenderness or organmegaly . However , his scortum appears oedematous . Respiratory rate is 28 breath\ min. and there are no respiratory signs.
What lab. would you order?
What is the diagnosis ?
What other investigations should to be performed at presentation?
What are the complications of this condition?