A child presented with cola coloured urine, proteinuria 2+ & h/o rash 2 week ago. Probable Dx
Ans: B (HSP) Gross hematuria (cola coloured urine) after upper respiratory tract infection; Time of latencyIgA nephropathy 1-2 days (Nelson 18th/2171)PSGN (After Pharyngitis or impetigo): 7-21 days (Nelson 18th/ 2171)HSP: 1-3 wk upto 12 wks (Nelson 18th/2179); also presents with systemic feature like rashHenoch-Schonlein Purpura (HSP); Short reviewIt is a systemic vasculitis that causes the blood vessels in the skin to become inflamed, causing red spots. When the blood vessels in the skin get inflamed, they can bleed, causing a rash that is called Purpura. This rash is typically seen on the lower legs or arms. The specific skin lesion is characterized by the tissue deposition of an immune system product, called IgA immunoglobulin, which is also found in kidneysof patients with a renal disease, called IgA nephropathy.HSP occurs more often in children than in adults, and many cases follow an upper respiratory tract infection (infection in your sinuses and /or lungs). Halfof affected children are under age five, although kidney involvement is more likely to be severe in older children. Compared to children, adults had more severe and frequent kidney involvement.Symptoms occur over a period of days to several weeks: Skin rash, joint aches and pains, usually in knees and ankles, occasional swelling, abdominal pain and renal disease manifesting mostly as hematuria (blood in your urine), proteinuria (abnormal excretion of proteins in urine), edema (swelling) or alteration in the volume of urine. The hematuria may be noticed as red or tea-colored or cola-colored urine or the amount may be so small that it can only be seen under a microscope. The brain or the lung may also be involved in HSP.Even though the symptoms of HSP make it easier to diagnose in children, confirmation of the diagnosis of HSP requires evidence of tissue deposition in the skin or kidney of IgA immunoglobulin. Renal biopsy is another method to establish the diagnosis, but is reserved for patients in whom the diagnosis is uncertain or in whom there is evidence of more severe renal involvement.
IgA nephropathy
HSP
HUS
Wegener Granulomatosis
Urinary Tract