A 9-year-old boy develops gross hematuria 24 hours after an upper respiratory tract infection. There is no edema, hypertension, or oliguria. Serum C3 is normal. Renal biopsy shows mesangial IgA deposition. Which statement is most correct regarding the prognosis?

• A Complete recovery occurs in >95% of cases
• B Progression to ESRD occurs within 5 years
• C Gross hematuria episodes typically recur with mucosal infections ✓
• D Corticosteroid therapy prevents long-term renal impairment

Explanation

This is IgA nephropathy (Berger disease). Gross hematuria characteristically appears within 1-3 days of a mucosal infection (synpharyngitic hematuria), distinguishing it from post-streptococcal GN (latency 1-2 weeks). Episodes recur with subsequent infections. Most children have a benign course, but complete recovery in >95% is an overstatement; 20-30% develop progressive disease over decades. Steroids are reserved for severe disease, not routine.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.