Final answer:
Based on the given case of a 2-year-old boy with a history of edema, low serum albumin, high serum cholesterol, and significant proteinuria without blood in the urine, the most likely diagnosis is Nephrotic syndrome, characterized by a damaged glomerulus and resultant loss of proteins into the urine.
Step-by-step explanation:
You are describing a clinical case in which a 2-year-old boy presents with a 1-week history of edema, generalized swelling, ascites, along with laboratory findings of low serum albumin (1.4 g/dL), high serum cholesterol (569 mg/dL), and proteinuria (4+ protein on urinalysis) without hematuria. Considering these findings, the most appropriate diagnosis to consider would be A) Nephrotic syndrome.
Nephrotic syndrome is characterized by the classic triad of massive proteinuria, hypoalbuminemia, and hyperlipidemia. The glomerulus in this condition is damaged, allowing a substantial amount of protein to pass from the blood into the urine. This syndrome often leads to generalized edema and ascites due to the reduction in plasma oncotic pressure from low albumin levels, as seen in this patient.
While acute glomerulonephritis, hemolytic uremic syndrome, Wilms tumor, and other kidney diseases could also present with some of these symptoms, the combination of marked proteinuria, hypoalbuminemia, high cholesterol, and the absence of hematuria is most suggestive of nephrotic syndrome in this pediatric patient.