A 15yo male has bilateral ankle edema. His BP=110/70mmHg and urinalysis shows protein++++.
What is the most likely dx?
a. HUS
b. IgA nephropathy
c. Membranous GN
d. Minimal change GN
e. Nephrotic syndrome
answer:D
Commonest cause of nephrotic syndrome in children is MCGN
Nephrotic syndrome: PALE
Proteinuria > marked
Albumin low
Lipids high
Edema
causes: in order of most proteinuria
• Minimal change GN …commonest cause in children
• Membranous GN…commonest cause of in adults
• FSGS
• Membranoproliferative GN
absent glomerular inflammation on biopsy: MCGN, FSGS
present glomerular inflammation on biopsy: MPGN, IgA nephropathy
Nephritic syndrome: PHAROH
Proteinuria mild
Hematuria
Azotemia = high BUN
RBC casts
Oliguria
HTN
causes:
with low c3
Post infectious GN (most common cause in children)
Membranoproliferative GN
SLE
with normal c3
IgA nephropathy (commonest cause in adults)
HSP( IgA variant)
Goodpasture’s syndrome