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Question |
I have a 10 y/o white male with 5 day hx of severe abdominal pain, afebrile with neg exam, specifically no rash. FH dad with hx of kidney transplant due to glomerulonephritis and a Hx of renal stones. Child had TNTC red cells. No proteinuria. H/H 41.9/15 smear revealed a few microcytes and mild poikilocytosis. MCV 79 platelets 345K. BUN 10, Creatinine 0.5. Ca 7.5, ionized Ca 3.18, Mg 2.28, Phos 5.3. Albumen 4.9, globulin 7.4. CT of abdomen and pelvis with and without contrast neg for hydronephrosis or calcification. Any ideas on differential dx and suggestion for further w/u.
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Answer |
One may need to know more details on the type of glomerulonephritis in the father as conditions such as IgA nephropathy, Alports syndrome may be familial. Since the child has severe abdominal pain and with a significant family hisoty and RBcs in urine, one may want to rule out familial glomerulopathies such as Alports syndrome. If we ignrore the family hisoty, conditions such as Porphyria ahould also be kept in mind.
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