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479 Pathology

An 8-year-old child has had abdominal pain and dark urine for 10 days. Physical examination shows blotchy purple skin lesions on the trunk and extremities. Urinalysis shows hematuria and proteinuria. Serologic test results are negative for MPO-ANCA (P-ANCA) and PR3-ANCA (C-ANCA). A skin biopsy specimen shows necrotizing vasculitis of small dermal vessels. A renal biopsy specimen shows immune complex deposition in glomeruli, with some IgA-rich immune complexes. Which of the following is the most likely diagnosis?

AGiant cell arteritis
BHenoch-Schonlein purpura
CPolyarteritis nodosa
DTakayasu arteritis
Pathology
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481 Pathology

A 40-year-old man complains of nausea, vomiting, diarrhea, and cramping abdominal pain. His temperature is 38degC , blood pressure 90/60 mm Hg, and pulse rate 90/minute. On physical examination, the patient appears dehydrated, with sunken eyeballs, dry tongue, and poor skin turgor. Hyperpigmentation is noted in the palmar creases and the gingival margins. Laboratory results include fasting serum glucose of 62 mg/dL, BUN of 27 mg/dL, Na of 122 mEq/L, and K of 6.5 mEq/L. Which of the following is the most likely cause of this patient’s symptoms?

AAmyloidosis
BAutoimmunity
CMetastatic cancer
DSarcoidosis
Pathology
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