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Old 08-11-2012
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Kidney Nephritic or nephrotic

A 14-year-old boy has pain in both knees, a color change in his urine, and bloody stools that occurred a few weeks following an upper respiratory infection. Palpable and painful lesions are present on the ankles and feet (see the photograph) and buttocks. Both knees are swollen, warm, and painful. Cardiorespiratory examination is unremarkable. Urinalysis shows hematuria with dysmorphic RBCs, RBC casts, and proteinuria > 3.5 g/24 hours. Which of the following immune responses is the most likely pathogenesis of this disorder?

This question was basically asked for diagnosis. With a image of a child's legs with lot of petechia. Dx is HSP.
But when i read the case i was wondering will we call it nephrotic or nephritic syndrome.
Nephritic- RBC cast
Nephrotic- > 3.5 protein
I think this patient got nephritic but progressing to nephrotic.
Hope i am thinking the right way if not suggestion welcomed.
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Old 08-11-2012
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Default IgA glomerulopathy

patient got a URTI-------> increased igA formed from the mucosal surfaces ------> inc load + dec clearance leads to ic deposition in the mesangium leading to hematuria and rbc casts

if the injury is long enough it can lead to nephrotic syn with increased proteinuria

igA glomerulopathy (bergers disease) has also overlaping features with HSP

I hope this helps
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