Case-1: Patient History J.H. is a 12-year-old boy diagnosed several months ago w
ID: 91779 • Letter: C
Question
Case-1: Patient History
J.H. is a 12-year-old boy diagnosed several months ago with nephrosis following postinfectious glomerulonephritis secondary to an episode of pneumococcal pneumonia. He has been coming to the clinic to have his condition monitored and therapies adjusted as needed. At his latest clinic visit, a decrease in urine output, increasing lethargy, hyperventilation, and generalized edema are noted. Trace amounts of protein are detected in J.H.’s urine by dipstick. Blood is drawn for laboratory analysis, and the results are as follows:
pH = 7.36
PaCO2 = 33 mm Hg
PaO2 = 100 mm Hg
HCO3 – = 18 mEq/L
Hct = 30%
Na+ = 130 mEq/L
K+ = 5.4 mEq/L
BUN = 58 mg/dl
creatinine = 3.9 mg/dl
albumin = 2.0 g/dl
Analyze this case study and answer the next four questions that follow.
Case-1: Question-1
Pneumococcal infection can lead to glomerulonephritis. Which of the following is true of postinfectious glomerulonephritis? (select all that apply)
A) Postinfectious glomerulonephritis is the result of an immune complex reaction.Explanation / Answer
The postinfectious glomerulonephritis followed by pneumococcal infection is occurs by a series of reactions. Like every pathogenic infection, here also an antigen-antibody reaction occurs after pneumococcal infection. This immunological reaction activates the complement pathway. The size of the resulting immunological reaction (antigen-antibody complex) and pore size of glomerular basement membrane is the main fact resulting to glomerular nephritis. The size of the antigen-antibody complex is much bigger than pore size of glomerular basement membrane. So the complex will be easily blocked in the glomerular basement membrane and capillary beds of the glomeruli. It will results in decrease in the GFR as well as increase in the membrane permeability, which are all together leads to acute glomerulonephritis.
The mentioned statements A, B and C are all true about postinfectious glomerulonephritis.