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Note what signs you see.
I (W. Wertelecki, M.D.) see a young girl with facial edema, in particular peri-ocular. Edema is NOT to be confused with “swelling”.
Among the first consideration is to determine the presence of infection (lymphadenitis in particular or ethmoidal sinuses) – another consideration is the mode of appearance (acute or gradual) – cold painless edema should trigger consideration of nephrosis.
One more consideration is nephrosis – in such instances, the edema may initially be intermittent (“off and on”) and is mostly peri-orbital, more prominent in mornings and as the day progresses, diminish while lower leg areas become edematous.
Please seek more information regarding causes of pediatric nephrosis from standard medical sources of clinical information.