A diverse group of patients presents to the nephrology clinic with various renal abnormalities. Match each patient's clinical presentation with the most likely underlying glomerular pathology.
- A 55-year-old man with a recent lung mass diagnosis presents with severe edema and an unprovoked deep vein thrombosis. Urinalysis shows 4.8 g/day of proteinuria.Membranous nephropathy
- A 28-year-old man presents with gross hematuria that began one day after the onset of a viral upper respiratory tract infection. He reports a similar episode last year.IgA nephropathy
- A 62-year-old woman with chronic untreated hepatitis C presents with palpable purpura, arthralgias, and new-onset hematuria with red blood cell casts.Membranoproliferative glomerulonephritis
- A 45-year-old man with poorly controlled HIV presents with worsening anasarca. Serum creatinine is 2.1 mg/dL, and urinalysis reveals 6.2 g/day of proteinuria.Focal segmental glomerulosclerosis
Answer
The lung mass with thrombosis matches Membranous nephropathy; the synpharyngitic hematuria matches IgA nephropathy; the Hepatitis C with purpura matches Membranoproliferative glomerulonephritis; and the HIV patient with nephrotic syndrome matches Focal segmental glomerulosclerosis.
Glomerular diseases often present similarly with edema and urinalysis abnormalities. Accurate diagnosis relies heavily on recognizing classic associations: Membranous nephropathy with solid tumors and thrombosis, IgA nephropathy with concurrent respiratory infections, Membranoproliferative glomerulonephritis with Hepatitis C, and Focal segmental glomerulosclerosis with HIV and heroin use.
Step-by-Step Solution
Key Concept
Differentiating glomerular diseases based on unique clinical associations and patient demographics.
Estimated Time:1m 30s