Proteinuria in a Child with Bone Pain and Pustular Lesions

Case presentation

A 12-year-old boy was admitted to our hospital with progressive musculoskeletal pain primarily affecting the lower extremities, neck, and back. His complaints had been present for 1 year and had worsened in the past month, leading to significant functional impairment, including walking difficulty. He also described night-time fevers of up to 40°C every 3–4 days for the past month. Family history was unremarkable. Physical examination revealed pustular skin lesions on the face, neck, and back. Musculoskeletal examination revealed pain in the left leg during internal and external rotation of both hip joints, difficulty in movement and walking due to pain, and mild pain in the cervical and upper thoracic vertebrae during anterior neck flexion. Initial laboratory tests showed elevated C-reactive protein (CRP): 102 mg/L (0–5 mg/L) and erythrocyte sedimentation rate (ESR): 32 mm/h (0–15).

Publication History

Received: 09 July 2025

Accepted: 09 October 2025

Article published online:
18 November 2025