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Pediatrics Urinary tract f716496f

A 8 year old male had non blanching rashes over the shin and swelling of knee joint with haematuria +++ and protein +. Microscopic analysis of his renal biopsy specimen is most likely to show

A
Tubular necrosis
B
Visceral podocyte fushion
C
Mesangial deposits of IgA
D
Basement membrane thickening
High-Yield Explanation
Henoch schonlein purpura : It is one of the most common vasculitic disorder of childhood. Characterised by the presence of nonthrombocytopenic , palpable purpura, transient ahralgia and abdominal symptoms. The illness begins with a rash more prominent over the extensor aspects of lower extremities and buttocks. It may be macular, maculopapular or even uicarial to begin with . Glomerulonephritis seen in one third of cases. Gastrointestinal manifestations usually occur in first 7-10 days if illness. Abdominal pain is intermittent, colicky and periumbilical.vomitingseen , whereas melena and hemetemesis are less common. Rare manifestations include CNS vasculitis, coma, Guillain Barre syndrome, pulmonary hemorrhage, carditis and orchitis. Criteria for childhood HSP:- Palpable purpura in the presence of at least one of the following 4 features: 1. Diffuse abdominal pain. 2. Any deposit showing IgA deposition. 3. Ahritis/Ahralgia. 4. Renal involvement.(hematuria) Investigation: Nonspecific rise in total serum IgA levels. Skin biopsy shows leukocytoclastic vasculitis. On indirect immunofluorescence there are mesangial deposits of IgA andC3 in skin and renal biopsy. Reference: GHAI essential Paediatrics

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