The patient is a 10-year-old female with a clinical presentation of HSP manifested by joint pain, nephrotic-range proteinuria, hematuria, abdominal pain, and typical skin rash.
Medical history:
None
Medications:
None
Physical Exam:
BP 90/60, showed puffy eyes, puffy ankles, puffy wrists.
The abdomen was benign. Cardiac and lung exams were normal.
Skin showed some mild purpura up to the navel area but not above.
Laboratory and other data:
Visit 1: Creatinine 0.55, HCO3 27
10 days later: Creatinine 2.1, HCO3 14
Hemoglobin of 11, platelets normal, IgA normal.
Persistently undetectable C4, ANA 1:320, Anti-DNA negative
Urinary protein to creatinine ratio ratio 45 (g/g), +Hematuria and pyuria on UA