A 4-Year-Old Girl Developed Acute-Onset Colicky Abdominal Pain, Vomiting, and Loose

A 4-year-old girl developed acute-onset colicky abdominal pain, vomiting, and loose bloody stools during a family vacation.  She was treated with supportive care and began to feel better.  A few days later, her parents bring her to the emergency department because she has urinated only once in the past 10 hours and the urine was red.  Physical examination shows conjunctival pallor but is otherwise normal.  Laboratory studies are as follows: Urinalysis shows proteinuria and hematuria.  Which of the following mechanisms is the most likely cause of this patient's condition?

A) Microthrombi in small blood vessels
B) Streptococcal antigen-associated glomerular damage
C) Systemic IgA-mediated vasculitis
D) Vasculitis involving medium arteries
E) Widespread activation of the coagulation cascade

Correct Answer:

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