Nephritic syndromes (pediatrics) Quiz: Ace Your Exams
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A 7-year-old boy is brought to the clinic for evaluation of recurrent episodes of hematuria, hemoptysis, and malaise for 3 weeks. There is no associated fever, joint pain, rash, or recent infection. Past medical is non-contributory. Family history is negative for renal disease. Temperature is 37°C (98.6°F), pulse is 90/min, respirations are 19/min, blood pressure is 130/75 mm Hg, and oxygen saturation is 98% on room air. Physical examination reveals mild periorbital edema and is otherwise normal. Laboratory results are shown below. Which of the following would confirm the diagnosis?
| Laboratory value | Result | Reference range |
| Serum chemistry | ||
| Sodium | 140 mEq/L | 138-145 mEq/L |
| Potassium | 4.2 mEq/L | 4.1-5.8 mEq/L |
| Chloride | 100 mEq/L | 96-106 mEq/L |
| Creatinine | 0.9 mg/dL | 0.1-0.5 mg/dL |
| Antibodies | ||
| Anti-glomerular basement membrane antibody (anti-GBM) | Negative | Negative |
| Anti-neutrophilic cytoplasmic autoantibody (ANCA) screen | Positive | Positive |
| c-ANCA | Positive | Negative |
| p-ANCA | Negative | Negative |
| Urine | ||
| Erythrocytes | 100/hpf | Negative |
| Leukocytes | 2/hpf | Negative |
| Urine specific gravity | 1.010 | 1.003-1.035 |
| Protein | +1 | Negative |
| Red blood cell casts | Positive | Negative |
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