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A diagnostic dilemma in a child with macroscopic hematuria, nephrotic syndrome and hypocomplementemia: Answers

  • Eren Soyaltın
  • Seçil Arslansoyu Çamlar
  • Demet Alaygut
  • Fatma Mutlubaş
  • Önder Yavaşcan
  • Seyhun Solakoğlu
  • Belde Kasap DemirEmail author
Article
  • 13 Downloads

Answers

  1. 1.

    In such a patient with nephritic and nephrotic components and hypocomplementemia, acute post-infectious glomerulonephritis (APIGN), particularly post-streptococcal glomerulonephritis (APSGN), is the first diagnosis to be considered. However, due to the lack of a history of upper respiratory tract infection or evidence for streptococcal infection, APIGN was initially excluded. The patient was diagnosed with C3 glomerulopathy (C3G) with a membranoproliferative pattern due to the light microscopy findings in addition to isolated C3 accumulation in IF.

     
  2. 2.

    Other pathologies including cryoglobulinemia, infective endocarditis, shunt nephritis, and lupus nephritis should also be considered in the differential diagnosis in addition to C3GN and APIGN. In our patient, cryoglobulinemia was excluded due to the absence of skin manifestations (ulcers or gangrene, livedo reticularis), vasomotor symptoms (Raynaud’s phenomenon and acrocyanosis), neurological symptoms, and/or musculoskeletal...

Keywords

Child Hematuria Nephrotic syndrome Hypocomplementemia C3 glomerulopathy Acute post-infectious glomerulonephritis APIGN 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© IPNA 2020

Authors and Affiliations

  • Eren Soyaltın
    • 1
  • Seçil Arslansoyu Çamlar
    • 1
  • Demet Alaygut
    • 1
  • Fatma Mutlubaş
    • 1
  • Önder Yavaşcan
    • 1
  • Seyhun Solakoğlu
    • 2
  • Belde Kasap Demir
    • 1
    • 3
    Email author
  1. 1.Department of Pediatrics, Division of NephrologyUniversity of Health Sciences, Tepecik Training and Research HospitalIzmirTurkey
  2. 2.Department of Histology and EmbryologyIstanbul University Medical FacultyIstanbulTurkey
  3. 3.Department of Pediatrics, Division of Nephrology and RheumatologyIzmir Katip Çelebi University Medical FacultyIzmirTurkey

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