Nephro Q -

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angel

if pple dont post answers on time, it gets lost in the hosts of other messages being posted. not good as it leaves a lot of doubt and confusion. so Mer post d answer

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Mer

The correct answer is E. This patient likely has Chrug-Struass syndrome. Chrug-Struass syndrome is a nephritic syndrome, which is associated with eosinophilia and asthma. This patient has nephritic syndrome as evidenced by edema, hypertension, and hematuria. Asthma is suggested by his nocturnal chest tightness and shortness of breath. Laboratory results reveal elevated eosinophils, which is typical in this condition. Chrug-Strauss is associated with a positive pANCA.

Goodpastures syndrome is typically defined as a combination of nephritic syndrome and pulmonary hemorrhage, although some patients have nephritic syndrome alone. The disease is mediated by antibodies to the glomerular basement membrane (choice A) and therefore those are the laboratory results often associated with the disease.

ASO (choice B) is associated with post infectious glomerulonephritis. Patients present with oliguria, hypertension, and edema. They classically complain of Coca-Cola colored urine. These infections classically occur 1-3 weeks after infection with nephritogenic group A streptococci (step throat or cellulitis).

Wegner granulomatosis is similar to Chrug-Strauss but respiratory involvement such as nasal septal perforation or sinus problems are typical presenting signs. Wegners doesn't have an association with asthma or increased serum eosinophils. The test associated with Wegners is cANCA (choice C).

Bergers syndrome (IgA nephropathy) presents in a similar manner to post-infectious glomerulonephritis but there is no latent period between infection and kidney involvement. These patients typically have gross hematuria after a viral illness. About 50% of these patients will have an elevated IgA (choice D).

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Sunny

Chrug-Struass syndrome is nephritic + asthma+eosiniphillia. this pt has only 2 wks h/o chest tightness and SOB, if it is Asthma it should have been chronic and more longer duration of history of breathlessness?? also Serum eosinophils mildly elevated.??? common things first - so ASO would be more appropriate to look for, any one can expalin?

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ankur

I think its the best fit theory.How will u explain the inappropriateness of the age group and the lack of cpoa coloured urine for post strept nephritis?And the chest findings and the elevation,even though mild,of eosinophils?Though i do agree that it isnt really the perfect fit for Churg Strauss either.