Question:easy
A 10 year old male child presented with generalised edema. His cholesterol was 238 mg/dl and urine protein was 3+. Stool microscopy showed fat in stool.
A 10 year old male child presented with generalised edema. His cholesterol was 238 mg/dl and urine protein was 3+. Stool microscopy showed fat in stool.
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Look for the combination of heavy proteinuria, oedema, and hyperlipidaemia in a child.
Updated On: Jun 23, 2026
- Goodpasture syndrome
- Urine infection
- Nephrotic syndrome
- Nephritic syndrome
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The Correct Option is C
Solution and Explanation
Systematic analysis of the clinical triad:
The child has three cardinal findings:
1. Generalised edema
2. Cholesterol $= 238$ mg/dl (hypercholesterolaemia)
3. Urine protein $3+$ (heavy proteinuria)
4. Fat in stool (steatorrhoea / lipiduria)
This combination matches nephrotic syndrome precisely. The pathophysiology is:
- Heavy glomerular protein leak $\rightarrow$ hypoalbuminaemia $\rightarrow$ reduced plasma oncotic pressure $\rightarrow$ oedema
- Liver upregulates lipoprotein synthesis to compensate for albumin loss $\rightarrow$ hyperlipidaemia
- Lipids spill into urine and bowel $\rightarrow$ lipiduria and steatorrhoea
Nephritic syndrome has predominantly haematuria + oliguria + mild proteinuria -- absence of marked hyperlipidaemia distinguishes it. Goodpasture syndrome = haemoptysis + haematuria. UTI does not cause oedema or hypercholesterolaemia.
Most common cause in a 10-year-old: Minimal Change Disease (MCD).
\[\boxed{\text{Nephrotic syndrome}}\]
The child has three cardinal findings:
1. Generalised edema
2. Cholesterol $= 238$ mg/dl (hypercholesterolaemia)
3. Urine protein $3+$ (heavy proteinuria)
4. Fat in stool (steatorrhoea / lipiduria)
This combination matches nephrotic syndrome precisely. The pathophysiology is:
- Heavy glomerular protein leak $\rightarrow$ hypoalbuminaemia $\rightarrow$ reduced plasma oncotic pressure $\rightarrow$ oedema
- Liver upregulates lipoprotein synthesis to compensate for albumin loss $\rightarrow$ hyperlipidaemia
- Lipids spill into urine and bowel $\rightarrow$ lipiduria and steatorrhoea
Nephritic syndrome has predominantly haematuria + oliguria + mild proteinuria -- absence of marked hyperlipidaemia distinguishes it. Goodpasture syndrome = haemoptysis + haematuria. UTI does not cause oedema or hypercholesterolaemia.
Most common cause in a 10-year-old: Minimal Change Disease (MCD).
\[\boxed{\text{Nephrotic syndrome}}\]
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