Question 157 · LEK · Nephrotic syndrome
A 7-year-old boy with a food allergy, with an history of anaphylactic shock after drinking of cow's milk, reports to the family doctor complaining of general weakness and eyelid swelling. The symptoms have persisted for over 2 days. Numerous fresh traces of insect bites are visible on the skin. Swelling of the face and lower legs. The heart rate and blood pressure are normal. The result of a rapid test determining the concentration of CRP in capillary blood - normal. Urine test strip: leukocytes (+), protein (+++). The child is referred to the hospital. What diagnosis do you consider the most likely at this stage?
- A. worsening of food allergy symptoms in a boy with a history of anaphylatic shock.
- B. suspected urinary tract infection.
- C. toxic reaction to insect bites.
- D. suspected allergy to insect venom.
- E. suspected nephrotic syndrome.
Hint
Focus on the urine dipstick: which finding dominates, and what does it imply together with facial and leg edema?
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