Case history
Case history #1
A 35-year-old man with no past medical history presents to the emergency department after he noted cola-coloured urine. He denies pain or fever associated with the blood in the urine, but has had a sore throat for the past 3 days, which is getting better. He has not had a similar episode previously. Examination reveals a non-blanching purpuric rash over both his legs. There are no other abnormalities.
Case history #2
A 42-year-old man with a medical history of HIV infection presents to his general practicioner with generalised swelling progressive for the past week. HIV was diagnosed a year ago and he has been non-compliant with the therapy prescribed. He denies orthopnoea, abdominal pain, nausea, and blood in his urine. He has non-pitting oedema mostly over the lower extremities but extending up to mid-abdomen.
Other presentations
GN can present with a nephritic syndrome (haematuria, sub-nephrotic-range proteinuria, and hypertension), with a nephrotic syndrome (nephrotic-range proteinuria, hypoalbuminaemia, hyperlipidaemia, and oedema), or with rapidly progressive glomerulonephritis (haematuria, proteinuria, and rising creatinine over weeks to months). Some patients present with just haematuria (macroscopic/microscopic) or proteinuria, or with both. In addition, patients have signs or symptoms of the underlying aetiological agent: for example, pharyngitis with streptococcal infection.
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