PAEDIATRIC CLINICAL NEPHROLOGY CONFERENCE |
Glomerulonephritis |
Chair: R. Coppo, Turin, Italy |
J.C. Davin, Amsterdam, The Netherlands |
Case of a boy presenting with microscopic hematuria
By R. Coppo and S. Emancipator
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Prof
S. Emancipator Professor at Institute of Pathology Case Western Reserve University Cleveland, OH, USA |
Case presentation:
The parents of a 14-year old boy wanted to consult a pediatric nephrologist about the persistent urinary abnormalities detected in their son. Microscopic hematuria (2+ by dipstick test) had been noted three years before, during a pre-sports physical examination. The rest of his past history and his family history were negative for hematuria, renal calculi, deafness or other kidney diseases.
Repeated urinalyses consistently disclosed 30-50 RBC/hpmf. Proteinuria was negative over the first 2 years, but then slowly increased to +/++ by dipstick; quantitative urinary protein excretion at the most recent visit was 1.2 g/day. Physical exam revealed an adolescent male in no distress; body weight was 55 kg, and height 165 cm. The BP was 110/50 mmHg, and no other abnormality was evident. Renal sonography was normal.
Laboratory analyses at our initial evaluation included serum C3 115 mg/dl, C4 14 mg/dl, IgG 961 mg/dl, IgA 229 mg/dl and IgM 76 mg/dl. Serology revealed negative/normal titers and/or antigens for ANA, ANCA, ASO, cryoglobulins, HIV, HCV and HBV antigens. Creatinine clearance was 102 ml/min/1.73 m 2.
