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5212 Pathology

A 7-year-old boy has become less active over the past 10 days. On physical examination, the boy has facial puffiness. Urinalysis shows no blood, glucose, or ketones, and microscopic examination shows no casts or crystals. The serum creatinine level is normal. A 24-hour urine collection yields 3.8 g of protein. He improves after corticosteroid therapy. He has two more episodes of proteinuria over the next 4 years, both of which respond to corticosteroid therapy. What is the most likely mechanism causing his disease?

ACytokine-mediated visceral epithelial cell injury
BCytotoxic T cell-mediated tubular epithelial cell injury
CIgA-mediated mesangial cell injury
DImmune complex-mediated glomerular injury
Pathology
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