A 9-year-old boy develops painless gross hematuria within 24 hours of an upper respiratory tract infection. Urinalysis shows dysmorphic red cells, proteinuria of 1 g/day, and serum C3 is normal. Two similar episodes occurred in previous years. What is the most likely diagnosis?
- A Post-streptococcal glomerulonephritis
- B IgA nephropathy ✓
- C Thin basement membrane disease
- D Membranoproliferative glomerulonephritis
Correct answer: B. IgA nephropathy
Explanation
Synpharyngitic gross hematuria occurring within 1 to 2 days of a respiratory infection, recurrent episodes, normal complement and modest proteinuria define IgA nephropathy, the commonest chronic glomerulonephritis worldwide. Post-streptococcal glomerulonephritis appears 1 to 3 weeks after infection with depressed C3, and its latency is the fact that kills that distractor. Thin basement membrane disease causes persistent asymptomatic hematuria without episodic gross hematuria tied to infections.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.