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Roxanita
10-26-2004, 10:03 AM
A 4-year-old girl is brought to the emergency department because of a 5-day history of fever, diffuse abdominal pain, nausea, vomiting, and diarrhea. Examination shows petechiae, hepatomegaly, and splenomegaly. Hemoglobin concentration is 8.7 g/dL and platelet count is 60,000/mm3. A peripheral blood smear shows erythrocyte fragmentation. Which of the following renal findings is most likely to be associated with her condition?

A) Glomerular crescent formation

B) IgG-associated glomerular basement membrane antibody

C) Membranoproliferative glomerulonephritis

D) Narrowing of the capillary wall by fibrin deposition

E) Periglomerular granuloma with giant cells

Anonymous
10-26-2004, 03:43 PM
It is "D". It is HUS (a form of TTP in children). Schizocytes are classically seen associated with thrombocytopenia and impairment of renal function.