skip to main content

PSGN Adult Prognosis Variable — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

ModerateGlomerulonephritisPSGN Adult Prognosis VariableESENeph

A 30-year-old woman presents with nephrotic syndrome. Biopsy shows dense subepithelial deposits ('humps') with IgG and C3 staining. She had a throat infection 3 weeks ago. ASO titre is elevated. C3 is low. What is the expected clinical course?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Post-streptococcal GN is usually self-limiting in children (>95% recover); in adults, recovery is less predictable – approximately 50-60% recover fully, but persistent hypertension, proteinuria, and CKD can occur in a significant minority

Post-streptococcal GN has a generally good prognosis in children (>95% full recovery). In adults, the outcome is less favourable: approximately 50-60% recover fully, but 15-30% develop chronic hypertension, persistent proteinuria, or progressive CKD. Risk factors for poor outcome include older age, heavy proteinuria, impaired GFR at presentation, and crescentic disease on biopsy. C3 should normalise within 6-8 weeks – persistent hypocomplementaemia warrants investigation for alternative diagnoses. Treatment is supportive – immunosuppression is not indicated for typical post-streptococcal GN.

Reference: KDIGO 2021 – GN (Infection-Related GN); Clark et al 2019 – PSGN Outcomes