A 17-year-old boy is brought to the physician because of swelling of his face and legs for 5 days. He has been healthy except for an episode of sore throat 2 weeks ago. His temperature is 37.0°C (98.6°F), pulse is 90/min, and blood pressure is 145/87 mm Hg. Examination shows periorbital edema and 3+ pitting edema of the lower extremities. .Laboratory results are as follows: Urinary protein excretion is 6.0 g/24 hr. A kidney biopsy is performed, and electron microscopy of a glomerular capillary is shown below: Which of the following is the most likely diagnosis?

Question

A 17-year-old boy is brought to the physician because of swelling of his face and legs for 5 days. He has been healthy except for an episode of sore throat 2 weeks ago. His temperature is 37.0°C (98.6°F), pulse is 90/min, and blood pressure is 145/87 mm Hg. Examination shows periorbital edema and 3+ pitting edema of the lower extremities. .Laboratory results are as follows:  Urinary protein excretion is 6.0 g/24 hr.  A kidney biopsy is performed, and electron microscopy of a glomerular capillary is shown below:  Which of the following is the most likely diagnosis?

Quizplus · Accepted Answer

Eductional Objective: Membranous nephropathy is a common cause of nephrotic syndrome in adults.  Electron microscopy of the glomerular capillary demonstrates irregular, subepithelial, electron-dense immune deposits on the glomerular basement membrane with moderate effacement of the podocyte foot processes; immunofluorescence microscopy demonstrates a diffuse granular pattern of IgG along the capillary loops.

A 17-Year-Old Boy Is Brought to the Physician Because of Swelling