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- Apr 10, 2016
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13 year old boy was brought in for a routine well-child exam. No history of prior serious illness. During the past 2 years he's complained of brown urine whenever he's had a cold. He has no complaints of urgency, dysuria, or incontinence. PE is unremarkable. Lab studies show:
Serum:
BUN: 15
Cr: 0.9
C3 90 mg/dL (nl 83-177)
Urine:
Blood 4+
Protein 3+
A) Hemorrhagic cystitis
B) HUS
C) IgA nephropathy
D) Nephrotic Syndrome
E) PSGN
The answer is supposed to be E, but I can't seem to understand why it's not C. Brown urine whenever he has cold sounds just like Berger disease. Unless he's had multiple episodes of PSGN with multiple strep pyogenes infections? And I've read IgA Nephropathy can cause proteinuria and hematuria as well, although mild. The Normal C3 also led me to choose C over E. Also no Past medical history of serious illness I'm assuming he never had a strep throat infection either. So I'm really confused.
Appreciate the help.
Serum:
BUN: 15
Cr: 0.9
C3 90 mg/dL (nl 83-177)
Urine:
Blood 4+
Protein 3+
A) Hemorrhagic cystitis
B) HUS
C) IgA nephropathy
D) Nephrotic Syndrome
E) PSGN
The answer is supposed to be E, but I can't seem to understand why it's not C. Brown urine whenever he has cold sounds just like Berger disease. Unless he's had multiple episodes of PSGN with multiple strep pyogenes infections? And I've read IgA Nephropathy can cause proteinuria and hematuria as well, although mild. The Normal C3 also led me to choose C over E. Also no Past medical history of serious illness I'm assuming he never had a strep throat infection either. So I'm really confused.
Appreciate the help.
