A 17-year-old male with nephrotic syndrome and diffuse adenopathy: questions

Excerpt

A previously healthy 17-year-old male presented to an outside hospital with a 5-day history of progressive bilateral lower extremity edema, abdominal distension, and abdominal pain. The patient also reported the recent development of a hyperpigmented, papular rash, 5 mm in size, on both his lower extremities and forearms, which he stated had resolved by the date of admission. He also noted that the frequency and amount of urine had decreased. Upon questioning, he remembered that he had a sore throat and cough 2 months prior to admission for which he was given an unknown antibiotic, although a culture was not obtained. Both a maternal and paternal aunt had end stage renal disease requiring dialysis in their fourth decade although neither of the aunts’ diagnosis was known by the family. The social history was negative for alcohol, tobacco, and drugs but positive for five female sexual partners and a previously treated chlamydia infection one year prior to admission. …