Endocarditis Immune Complex GN — ESENeph MCQ

Correct answer: D — Targeted antibiotics and endocarditis source control

The best answer is “Targeted antibiotics and endocarditis source control”. Endocarditis-associated GN is driven by ongoing infection and immune-complex formation. Targeted prolonged antibiotics and valve/source management are fundamental, with supportive AKI care and reassessment if kidney inflammation persists after infection control. “Give glucocorticoid monotherapy while leaving the infection untreated” is less appropriate because immunosuppression can worsen active infection and does not remove the antigen source “Treat as primary IgA nephropathy without blood-culture-directed therapy” is less appropriate because the concurrent endocarditis and biopsy context define infection-related disease “Use plasma exchange as routine first-line treatment” is less appropriate because plasma exchange does not eradicate the bacterial driver “Start complement inhibition before antibiotics” is less appropriate because standard management prioritises infection eradication and supportive kidney care

Reference: KDIGO 2021 glomerular diseases guideline: https://kdigo.org/wp-content/uploads/2021/10/KDIGO-2021-Guideline-for-the-Management-of-Glomerular-Diseases.pdf