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Post-Streptococcal GN — ESENeph MCQ

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EasyGlomerulonephritisPost-Streptococcal GNESENeph

A 25-year-old man presents with visible haematuria, mild proteinuria, and a low C3 with normal C4. He had a sore throat 14 days ago. ASO titre is elevated. Kidney biopsy shows diffuse endocapillary proliferation with subepithelial humps on EM. IF shows granular C3 and IgG staining ('starry sky' pattern). What is the diagnosis?

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Correct answer: C — Post-streptococcal glomerulonephritis

The constellation of haematuria 10-21 days after pharyngitis, low C3 with normal C4, elevated ASO titre, endocapillary proliferation, subepithelial humps on EM, and granular IgG/C3 is classic for post-streptococcal GN. IgA nephropathy presents within 1-2 days of URTI (synpharyngitic), has normal complement, and shows mesangial IgA on IF. C3 glomerulopathy has dominant C3 without significant IgG. Post-streptococcal GN is usually self-limiting; complement normalises within 6-8 weeks.

Reference: KDIGO 2021 – Glomerular Disease Guideline (Infection-Related GN)