. An 8-year-old boy is brought to the pediatrician\'s office with a 2-day histor
ID: 64408 • Letter: #
Question
. An 8-year-old boy is brought to the pediatrician's office with a 2-day history of malaise, fever to 102°F, nausea, and vomiting. His mother reports that he has decreased urine output and that his urine is a dark, smoky color. His blood pressure is slightly elevated, and there is some swelling of his hands and feet and around his eyes. He has been in good health except for a sore throat a week or so ago. What is the most likely diagnosis? What mechanism is involved? What is the usual clinical course?
Explanation / Answer
Most likely diagnosis: Nephritic syndrome, most likely caused by poststreptococcal glomerulonephritis (GN).
Mechanism: Immunologic reaction against nephritogenic beta-hemolytic streptococci leading to immune complexes in the glomeruli.
Usual clinical course: Excellent prognosis for recovery.
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