A curious case of facial swelling

We present our case of a 16 year old boy presenting to us with shortness of breath and having features of both nephritic and nephrotic syndrome leading to intubation and ventilation due to pulmonary embolism. Nephrotic syndrome is characterised by heavy proteinuria (>3g/24hrs), hypertension, hypercholesterolemia, hypoalbuminemia, anasarca and microscopic hematuria whereas nephritic syndrome is characterised by the presence of proteinuria (1-2g/24hrs), hematuria, pyuria, hypertension, red blood cell casts, fluid retention, rise in serum creatinine with reduction in glomerular filtration rate. Both the diseases are separate entities however in certain cases, there can be overlapping of the components of both this syndrome.