We had a great case of acute glomerular nephritis, which was ultimately found to be (HSP). This is a disease that usually effects children, however when it does present in adult hood it presents with palpable purpura, abdominal pain or abdominal bleeding as well as arthritis and acute GN. The rash is usually symmetric and on lower extremities, buttock and arms. It is thought to be due to IgA deposits in the skin, GI tract and in the kidneys. Thus serum IgA is sometimes positive.
When thinking about acute GN, we can think about it from a laboratory marker standpoint, however this is only to make sure you remember all of the GN’s, you should use your knowledge of each illness script to see if your patient fits as the laboratory markers will take a while to return.
+ANCA: GPA, MP, EGPA
+Anti-GBM: Goodpasture’s, Anti-GBM dz
↓C3/↓C4: PSGN, MPGN, SLE, IE, Cryoglobulinemia
Other: IgA, HSP