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Case Records of the Massachusetts General Hospital
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Volume 358:941-952 February 28, 2008 Number 9
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Case 7-2008 — A 17-Year-Old Girl with Chest Pain and Hemoptysis
T. Bernard Kinane, M.D., Eric F. Grabowski, M.D., Sc.D., Amita Sharma, M.D., Katherine Nimkin, M.D., Mary Etta King, M.D., and Lynn D. Cornell, M.D.

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Presentation of Case

Dr. Mary Shannon Fracchia (Pediatrics): A 17-year-old girl was transferred to this hospital because of chest pain and hemoptysis. She had been well except for mild asthma until 4 months earlier, when pedal edema developed; testing revealed 3+ proteinuria, hematuria, and hyperlipidemia. One month later, a renal biopsy was performed at another facility, and a diagnosis of membranous glomerulonephritis was made. Testing for antibodies to hepatitis B and hepatitis C, as well as antiribonuclear protein, antitopoisomerase I, anti-Smith, anti-Ro (SS-A), anti-La (SS-B), anti–double-stranded DNA, and antinuclear antibody was negative. The levels of serum C3 and C4 complement were normal. Enalapril, . . . [Full Text of this Article]

Management of Pulmonary Embolism

Thrombolytic Therapy for Pulmonary Embolism

Thrombolysis and Anticoagulation for Pulmonary Embolism

            Risk Factors for Pulmonary Embolism

            Anticoagulation in the Nephrotic Syndrome

Clinical Diagnosis

Pathological Discussion

Management of Membranous Glomerulonephritis

Anatomical Diagnosis


Source Information

From the Departments of Pediatrics (T.B.K., E.F.G., A.S., M.E.K.), Radiology (K.N.), and Pathology (L.D.C.), Massachusetts General Hospital; and the Departments of Pediatrics (T.B.K., E.F.G., A.S., M.E.K.), Radiology (K.N.), and Pathology (L.D.C.), Harvard Medical School.




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