A 12-year-old boy with dyspnea, hypertension, hematuria, and proteinuria.

Case: A 12-year-old boy presented to the emergency department with progressive dyspnea for 1 week and bilateral periorbital edema for 1 day. On review of systems, he reported an upper respiratory tract infection 1 week before the onset of dyspnea. A review of vital signs showed a temperature of 99.8°F (37.7°C), heart rate of 99 beats/min, blood pressure of 167/117 mm Hg, respiratory rate of 22 breaths/min, and oxygen saturation of 99% on room air. In addition to periorbital edema, the patient appeared to have worsening dyspnea when he was placed supine.