Case presentation:
A 9-year-old girl presents with proteinuria. One year previously she had been treated
for streptococcal pharyngitis with a normal follow-up urinalysis. Four months previously
she had an episode of fever followed by proteinuria and hematuria. At that time, her
workup included the following:
- Urinalysis with
- 25 red cells per high-powered field
- 3+ proteinuria (2.8 grams/24 hr)
Serum cholesterol of 378 mg/dl (normal <200 mg/dl)
- Serum protein electrophoresis showed an increased alpha-2 band
- BUN and creatinine were normal
- BP 100/45
- No edema
- Negative anti-streptolysin-O titres and throat cultures
The current physical exam was unremarkable and the following labs were obtained:
- Urine
- Specific gravity 1.01, 1+ protein
- BUN 15 mg/dl
- Serum creatinine 0.4 mg/dl
Questions:
- Was the girl's presentation 4 month's previously related to her
streptococcal pharyngitis 1 year previously?
- How would assess her presentation 4 month's previously?
- What to you think of her current presentation?
