Case history
Case history #1
A 35-year-old man with no past medical history presents to the emergency department after he noted cola-colored 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. Exam reveals a nonblanching 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 primary care physician with generalized swelling progressive for the past week. HIV was diagnosed a year ago and he has been noncompliant with the therapy prescribed. He denies orthopnea, abdominal pain, nausea, and blood in his urine. He has nonpitting edema mostly over the lower extremities but extending up to mid-abdomen.
Other presentations
GN can present with a nephritic syndrome (hematuria, subnephrotic-range proteinuria, and hypertension), with a nephrotic syndrome (nephrotic-range proteinuria, hypoalbuminemia, hyperlipidemia, and edema), or with rapidly progressive GN (hematuria, proteinuria, and rising creatinine over weeks to months). Some patients present with just hematuria (macroscopic/microscopic) or proteinuria, or with both. In addition, patients have signs or symptoms of the underlying etiologic agent: for example, pharyngitis with streptococcal infection.
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