A 12 year old girl presents with complaints of swelling and dark urine. She has a family history of rheumatoid arthritis but she is well and has no significant medical history.

When you examine her you find sacral oedema. Her blood pressure is high and her urine dipstick shows 4+ blood, 2+ protein.

It is decided to admit her for treatment and further work-up. Her complement levels come back low from the laboratory.

Which three of the following could be her underlying diagnosis?

SLE


Polyarteritis nodosa


Post-streptococcal glomerulonephritis

Shunt nephritis


IgA nephropathy


Hepatitis C

SLE
Post-streptococcal glomerulonephritis
Hepatitis C

Although shunt nephritis is a cause of low complement levels she has no previous history, so shunt nephritis is not a realistic possibility in this scenario.

Causes of low complement nephritis:
• Post infectious glomerulonephritis
• SLE
• Cryoglobulinaemia
• Shunt nephritis
• Membranoproliferative glomerulonepritis
• Infective endocarditis

Causes of normal complement nephritis:
• HSP
• Goodpasture’s syndrome
• PAN
• Wegener’s granulomatosis
• IgA nephropathy