8/2/2019 Kasus CS Buatan

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A boy, 7 years old. An Elementary student in a government school. Lives in Tangerang

Come with his mom, with chief complaint: abdominal pain

HPI

Pain : episodic abdominal pain since 3 days ago, migrate to flank and back region, severity 6-7

no joint pain

His mother notices there is edema around his eyes, sudden onset, prominent upon awakening in

the morning. There is also edema around ankle, indented after wearing socks.

Dark colored urine since 2 days ago. Urine appear darker, brown-colored.

Wasnt urinating much since 2 days ago

Headache

Fever, weakness, malaise,

No rash, No purpura

Family history : his brother had mild cough 3 weeks ago, recover after taking cough syrup

his father and grandfather has history of controlled hypertension,

his grandmother has history of asthma

Nutrition : eat and drink well. Usually buy food from school canteen, food stall on the street

Social : still go to school everyday but doesnt play with his friends because feel weak

Past illness +medication : sore throat + cough + fever 2 weeks ago, recover after taking

antibiotic + GG + PCT from puskesmas

Hospitalization : -

Immunization : complete

Drug/alcohol/smoking : -

Lab : Hematuria

Proteinuria below nephrotic range

8/2/2019 Kasus CS Buatan

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Inquire about symptoms of acute glomerulonephritis, including the following:

Hematuria - This is a universal finding, even if it is microscopic. Gross hematuria isreported in 30% of pediatric patients, often manifesting as smoky-, coffee-, or cola-

colored urine.

Oliguria

Edema (peripheral or periorbital) - This is reported in approximately 85% of pediatricpatients; edema may be mild (involving only the face) to severe, bordering on a nephroticappearance.

Headache - This may occur secondary to hypertension; confusion secondary to malignanthypertension may be seen in as many as 5% of patients.

Shortness of breath or dyspnea on exertion - This may occur secondary to heart failure orpulmonary edema; it is usually uncommon, particularly in children.

Possible flank pain secondary to stretching of the renal capsuleAsk about symptoms specific to an underlying systemic disease that can precipitate acute GN

(see Etiology). Classic presentations include the following:

Triad of sinusitis, pulmonary infiltrates, and nephritis, suggesting Wegenergranulomatosis

Nausea and vomiting, abdominal pain, and purpura, observed with Henoch-Schnleinpurpura

Arthralgias, associated with systemic lupus erythematosus (SLE) Hemoptysis, occurring with Goodpasture syndrome or idiopathic progressive

glomerulonephritis

Skin rashes, observed with hypersensitivity vasculitis or SLE; also possibly due to thepurpura that can occur in hypersensitivity vasculitis, cryoglobulinemia, and Henoch-

Schnlein purpura