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A 10-year-old male presents with his mother, who appears very anxious. She reports several episodes of red-brown urine this morning. The patient reports feeling a bit tired, but otherwise, has no complaints. At age 5, he had myringotomy tubes placed bilaterally, but his past medical history is otherwise unremarkable. He takes no medications. On review of systems, he reports a sore throat that completely resolved a few days ago.

LATER, you find a pleasant young man in no acute distress. He is afebrile. His blood pressure is 140/94 mm Hg, and he has trace pretibial edema. The remainder of the unrevealing. Urinalysis shows 2+ blood, 2+ protein, specific gravity 1.015, and numerous red blood cells with red cell casts. BUN is 35 mg/dL and creatinine is 1.8 mg/dL. CBC (Complete Blood Count), coagulation studies, and electrolytes are all normal. Throat culture grows group A beta-hemolytic streptococcus.

Questions:

  1. What do you think is going on?
  2. What is the causative agent of this disorder?
  3. Which best describes the usual course of post-streptococcal glomerulonephritis?
  4. Which are the signs and symptoms of this disease? Is this case a typical one?
  5. What is the mechanism of this disease?
  6. What are the course of the disease and compare adult vs? Children

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