A Paediatric Renal Dilemma

Author: Maria Angela Garcia / Editor: Sarah Edwards / Codes: NepC1, SLO5 / Published: 08/06/2023

A 5-year-old, previously healthy boy presents to the emergency department (ED) with a two-week history of neck swelling with progressive involvement of hand, abdomen, ankles, and feet. Otherwise systemically well, eating and drinking with good energy levels.

The child’s mother denies any recent illnesses such as fevers, cough, rhinorrhoea, gross haematuria, or gastrointestinal symptoms. There are no sick contacts and no known family history of importance.

Physical examination has revealed that the child was alert, afebrile with normal observations. Facial puffiness is noted with significant swelling in hands, feet, and lumbar spine. Cardiovascular, respiratory and head, eyes, ears throat and nose exam is unremarkable. A urine dipstick shows proteinuria (protein 3+) and microscopic haematuria (blood 3+).