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Clinical application

Claire Diego is an 11 year old girl living in Los Angeles. Shecomplains of having to urinate more frequently with a large urinevolume. She also is very thirsty. She has no previous illnesses,except that 6 weeks ago she developed a sore throat. It persistedfor 2.5 weeks until she was seen by her pediatrician. At that timeit cleared over the next 2 weeks with antibiotics. She is currenton her vaccinations. She has had no travel out of the State ofCalifornia in her life. The family has no pets or contact withwildlife.

Her physical exam is unremarkable.

Her blood pressure is 120/77.

Other lab values:

Blood sugar = 99

ADH level = normal

Aldosterone level = normal

Urinalysis:

albumin = 5+

RBC’s = 40-50/HPF

Urine culture = negative

***If I said this was a renal corpuscle problem, what link canyou see to the sore throat in her history?

Hint: how could antigen/antibody complexes and complement,then inflammation, from the immune system be involved in theetiology of the abnormality?

Look again at filtration pressures in the renal corpuscle.Which one of the pressures would now be abnormal in this patient?_____________.

Assign that pressure 14 mmHg.

Now draw a picture of the forces effecting filtrate flowthrough this patient’s renal corpuscle and show why she is sheurinating more. Show her NFP.