Question

A 4 year old Hispanic child is brought to his pediatrician after he developed swelling of his eyes and ankles over the past week. Temperature is 37.4 C (99.3 F), pulse is 120/min, blood pressure 104/61, and respirations 28/min. In addition to periorbital swelling and 2+ edema of the ankles, he has a protuberant abdomen with a positive fluid wave. Laboratory evaluation shows BUN 7 mg/dL, creatinine 0.4 mg/dL, albumin 1.4 g/dL, and cholesterol 498 mg/dL. Urinalysis shows no blood and 4+ protein. Which of the following is the most likely associated finding in this patient's disorder?

A. Apple green"" birefringence under polarized light with Congo red stain
B. Fusion of epithelial foot processes on electron microscopy
C. Low complement C3 and increased anti-streptolysin O titer
D. Presence of cytoplasmic anti-neutrophil antibody (ANCA) staining
E. Granular deposits of IgG and C3 in the basement membrane

Answer 1

The most likely associated finding in this patient's disorder is Granular deposits of IgG and C3 in the basement membrane. This is characteristic of membranous nephropathy, a common cause of nephrotic syndrome in children. Correct option is E.

Step-by-step explanation:

The most likely associated finding in this patient's disorder is Granular deposits of IgG and C3 in the basement membrane.

Based on the patient's presentation of swelling of eyes and ankles, protuberant abdomen, low albumin, high cholesterol, and 4+ proteinuria, the most likely diagnosis is nephrotic syndrome.

Nephrotic syndrome is characterized by increased membrane permeability, leading to loss of protein in the urine (proteinuria) and resulting in hypoalbuminemia, edema, and hyperlipidemia. The granular deposits of IgG and C3 in the basement membrane are characteristic of membranous nephropathy, a common cause of nephrotic syndrome in children.

Therefore, option E - Granular deposits of IgG and C3 in the basement membrane - is the most likely associated finding in this patient's disorder.