Reference no: EM133621461
Case: A 13-year-old boy presented to the clinic complaining of a sore throat, fever, and malaise. The mother reports that he has had a sore throat with fever, nausea, and malaise for 4-5 days about 1 week ago. She thought it was just a cold and he seemed to get better so she did not take him in for evaluation but 2 days ago his symptoms returned. She decided to bring him in for an evaluation. She also has noted that he has become tachypneic and short of breath. She noted that his eyes were puffy, his ankles were swollen, and his urine was dark and cloudy.
On examination, the child's blood pressure was 148/100 mmHg, his pulse was 122 beats/minute, and his respirations were 35 breaths/minute. Orbital and ankle edema were present. Crackles were auscultated bilaterally. No heart murmurs were found. Slight tenderness to percussion over the flank area was noted.
A chest x ray showed evidence of congestion and edema in the lungs. The patient's hematocrit was 37%, and his WBC count was 11,200/mm. Blood urea nitrogen was 48 mg/dL (normal is less than 20mg/dL. Urinalysis results showed that the patient's protein was 2+ (24-hr excretion was 0.8g), specific gravity was 1.012, and moderate amounts of RBC's and WBC's were in the urine. Serum albumin was 4.1 g/dL (normal is 3.5-4.5)
Question 1: Which evidence supports the conclusion that this patient has kidney disease? What is the probable cause of his kidney disease?
Question 2: Which clinical pattern of kidney disease does this patient have? Explain the symptoms?
Question 3: Which morphologic changes would you expect in the kidney?
Question 4: What is the prognosis? What are the possible short-term complications of this disease? Is it necessary to hospitalize the patient?