Patient's question:
A period of time, face and eyes swelled, almost disappeared by noon. The next day, slight swelling appeared upon waking, disappearing on its own by noon. There was a sensation of needing to urinate but unable to. On the evening of the sixth day, there was intense activity. On May 7th, the swelling became severe again.Doctor's answer:
The child has hematuria and proteinuria, elevated erythrocyte sedimentation rate, and morning eyelid edema. Kidney disease should be considered, with a high likelihood of glomerular disease. Based on their age, possible conditions include post-infectious glomerulonephritis, as the anti-O titer is normal and serum complement levels are normal, making non-streptococcal infection more likely; IgA nephropathy, where hematuria or proteinuria may appear after an infection, and some children may have normal or improved urinalysis results after infection control; mesangial proliferative nephritis, etc. Among these, the first condition generally has a relatively better prognosis, with a course of six to eight weeks, where clinical symptoms usually disappear, but microscopic hematuria may persist for a longer time. Other conditions vary from person to person, and it is important to monitor subsequent episodes. The child's current proteinuria is close to normal, and their general condition has improved. If there are no discomfort symptoms or edema, medication may not be necessary, but regular urinalysis should be performed. Diagnosing nephritis is generally more challenging, and the course of the disease is often used to observe and infer the diagnosis. A definitive diagnosis requires a kidney biopsy. If persistent proteinuria or intermittent positive results and gross hematuria occur, a kidney biopsy is recommended early to confirm the diagnosis and develop an appropriate treatment plan based on the pathology.