Question

A 10 year old male child presented with generalised edema. His cholesterol was 238mg/dl and urine protein was 3+. Stool microscopy showed fat in stool.

• A. Goodpasture syndrome
• B. Urine infection
• C. Nephrotic syndrome
• D. Nephritic syndrome

Answer 1

The Correct Option is C

The clinical presentation described in the question is characteristic of Nephrotic syndrome. Let's analyze the key features:

• Generalized edema: Nephrotic syndrome often presents with significant fluid retention and swelling due to low serum protein levels that affect osmotic balance.
• Cholesterol level of 238 mg/dL: Hyperlipidemia is commonly associated with nephrotic syndrome as the body attempts to compensate for protein loss by increasing lipid production.
• Urine protein 3+: Heavy proteinuria is a hallmark of nephrotic syndrome, typically defined by protein levels greater than 3.5 grams per day. The 3+ indicates a significant amount of protein being excreted in urine.
• Fat in stool (steatorrhea): While not a primary symptom, it can occur in nephrotic syndrome due to concurrent gastrointestinal involvement or dietary changes.

These characteristics align with nephrotic syndrome, setting it apart from the other conditions listed:

• Goodpasture syndrome: Primarily involves pulmonary and renal symptoms with hemoptysis and hematuria, not primarily proteinuria and edema.
• Urine infection: Typically presents with dysuria, pyuria, or bacteriuria, not with systemic symptoms like edema and severe proteinuria.
• Nephritic syndrome: Usually associated with hematuria, hypertension, and mild proteinuria, contrasting with the severe proteinuria seen here.

Therefore, based on the clinical evidence, the most accurate diagnosis is Nephrotic syndrome.