Keywords
- 5 y/o boy
- progressive swelling of lower limbs & puffy face (2 weeks)
- swelling of abdomen (1 week)
- Frothy urine
- easily tired, breathless on exertion
- examined by doctor: generalised oedema, hydrothorax, ascites, gross pitting pedal oedema
- CVS normal
- Hb low
- Urea & creatinine normal
- Serum albumin low
- Alkaline transaminase & alkaline phosphatase normal
- Urinalysis: Protein present, no blood
- 24 hour urinary protein: 5gm (high)
Hypothesis
Renal disease/failure
Nephrotic syndrome
Acute nephritic syndrome
Asymptomatic hematuria/proteinuria
Chronic renal failure
Rapidly progressive glomerulonephritis
Learning issues
1)Syndromes
- Nephrotic syndrome
- Acute nephritic syndrome
- Asymptomatic hematuria/proteinuria
- Chronic renal failure
- Rapidly progressive glomerulonephritis
– Causes (primary & secondary)
– Pathogenesis
– Complications
– Prognosis
2) Acute glomerulonephritis
– How is it different from nephritic syndrome
3) Explanation for clinical features
– generalized oedema
– gross pitting pedal oedema
– hydrothorax
– ascites
– abdominal swelling
– frothy urine (protein)
– tired, breathless on exertion
4) Investigations
– Staining
– Biopsy
– Low hb (anemia)
– Urea & Creatinine normal
– Hypoalbuminemia
– Normal alkaline transaminase & alkaline phosphatase (liver)
– Protein in urine, no blood in urine
– Cholesterol
5) Treatment
– Outline