A 10-year-old boy develops nephritic syndrome 2 weeks after a streptococcal throat infection. Renal biopsy immunofluorescence shows 'starry sky' pattern of coarse, granular IgG and C3 deposits in a lumpy-bumpy distribution. EM shows large, hump-shaped subepithelial deposits. The correct name for these deposits is:

• A Subepithelial humps ✓
• B Subendothelial deposits ('wire-loop' pattern)
• C Mesangial deposits
• D Intramembranous dense deposits (dense deposit disease)

Explanation

Post-infectious (post-streptococcal) glomerulonephritis is the classic immune complex nephritis in children presenting as nephritic syndrome 10–21 days after streptococcal pharyngitis. The EM hallmark is large, hump-shaped subepithelial immune deposits (composed of IgG, complement). On immunofluorescence, these produce the characteristic coarse, granular ('starry sky' or 'lumpy-bumpy') pattern of IgG and C3 along capillary walls. Subendothelial deposits with 'wire-loop' appearance are seen in lupus nephritis class III/IV; mesangial deposits dominate in IgA nephropathy; intramembranous dense deposits define C3 glomerulopathy (dense deposit disease).

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.