A 7-Year-Old Boy Is Brought to the Emergency Department by His

question 97

Multiple Choice

A 7-year-old boy is brought to the emergency department by his parents for arthralgias.  He had a cough and runny nose last week but otherwise has been in good health.  Temperature is 37 C (98.6 F) , blood pressure is 95/65 mm Hg, pulse is 92/min, and respirations are 20/min.  Physical examination shows raised, red-purple papules, some of which have coalesced, over the patient's buttocks and thighs.  Auscultation of the lungs and heart is normal.  The abdomen is soft with normal bowel sounds.  The knees are tender but do not appear warm or swollen.  Urinalysis results are as follows: Which of the following mechanisms is the most likely underlying cause of this patient's renal findings?

• A)Autoantibodies against podocyte antigens
• B)Autoantibodies to host cell basement membranes
• C)Immune complex deposition in glomerular mesangium
• D)Thrombosis of glomerular capillaries
• E)T-lymphocyte cytotoxicity against virally-infected mesangial cells

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