Q. A six year old male child presents with acute onset of decrese in urine output associated with generalised edema. Examination revealed HR-94/min, RR-20/min, BP-140/100mmHg.There was generalised anasarca with pallor.

CBC revealed hemoglobin of 6.9 g/dl. serum chemistry revealed BUN-100mg/dl and Creatinine of 3 mg/dl. Urine examination revealed plenty of dysmorphic RBC, RBC casts with 2+ proteinuria. 24 hr urinary protein was 1 gm. ASLO and antiDNAase titres were negative. ANCA was negative and C3 levels were low.

Which of the following is not a possibility?
a}Essential cryoglobulinemia
b}Lupus nephritis
c}Henoch-Schonlein purpura
d}Bacterial endocarditis
e}Membranoproferative glomerulonephritis

Answer: c
In a child with nephritic syndrome, hypocomplementemia is present in Post-infectios GN, lupus nephritis, cryoglobulinemia, bacterial endocarditis, shunt nephritis, MPGN, and idiopathic proliferative GN. In post-streptococcal, ASLO will be expected to be positive. C3 will be normal in HSP, IgA nephropathy, fibrillary GN, and GN associated with visceral abscess.