A 7-year-old child presents with gross hematuria (tea-colored urine), periorbital edema, hypertension (BP 148/96 mmHg), and oliguria 2 weeks after a streptococcal sore throat. Urinalysis shows red cell casts. The pathological lesion MOST likely to be found on renal biopsy is:
- A Diffuse mesangial IgA deposits (IgA nephropathy)
- B Diffuse endocapillary proliferative glomerulonephritis with subepithelial humps ✓
- C Focal segmental glomerulosclerosis
- D Membranous glomerulonephritis with spike-and-dome deposits
Correct answer: B. Diffuse endocapillary proliferative glomerulonephritis with subepithelial humps
Explanation
Post-streptococcal glomerulonephritis (PSGN) presents 10–21 days after throat or skin Streptococcal infection with acute nephritic syndrome. The classical biopsy finding is diffuse endocapillary proliferative glomerulonephritis with characteristic 'humps' — large subepithelial immune deposits of IgG and C3 on electron microscopy. Immunofluorescence shows a 'starry sky' pattern of granular IgG and C3. IgA nephropathy presents with hematuria concurrent with (not 10–21 days after) an upper respiratory infection.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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