Approach to proteinuria (pediatrics) Quiz: Ace Your Exams
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A 4-year-old girl presents to the emergency department due to decreased activity and fever for three days. Parents have been giving her antipyretic agents for the fever. She has also had vomiting and diarrhea for two days. Past medical history is significant for seizure disorder that is well controlled on antiseizure medication. Temperature is 37� C (98.6�F), pulse is 125/min, respirations are 20/min, and blood pressure is 90/48 mm Hg. There is no jaundice, skin rash or edema. Mucous membranes are dry and capillary refill is greater than two seconds. Cardiopulmonary and abdominal examinations are normal. Laboratory results are shown below. Which of the following is the most probable cause of this condition?
| Laboratory value | Result |
| Blood | |
| pH | 7.14 |
| PCo2 | 42 mmHg |
| Bicarbonate | 12 mmol/L |
| Serum | |
| Potassium | 4.6 mEq/dL |
| Blood urine nitrogen | 30 mg/dL |
| Creatinine | 1.7 mg/dL |
| Urine | |
| pH | 6 |
| Protein | +1 |
| RBCs | 20/hpf |
| WBCs | 2/hpf |
| Casts | Muddy brown casts |
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