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IgA vasculitis nephritis — MRCPCH FOP MCQ

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HardRenalIgA vasculitis nephritisMRCPCH FOP

A 6-year-old boy has palpable purpura over the buttocks, ankle pain and colicky abdominal pain. Urine dipstick shows blood 2+ and protein 1+; blood pressure is 118/78 mmHg. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Urine protein:creatinine ratio with blood pressure monitoring

This is IgA vasculitis with renal involvement, so quantifying proteinuria and monitoring blood pressure are essential. Skin biopsy is usually unnecessary in a typical presentation. Abdominal pain can occur in IgA vasculitis and does not by itself indicate appendicectomy. The pearl is that renal disease determines long-term risk, so urine and blood pressure follow-up must be arranged.

Reference: NICE CKS Henoch-Schonlein purpura; BAPN guidance