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Post-Streptococcal Glomerulonephritis — RACP Paediatrics MCQ

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ModerateNephrologyPost-Streptococcal GlomerulonephritisRACP Paediatrics

A 7-year-old girl presents with haematuria, periorbital oedema, hypertension (140/95 mmHg), and dark ('cola-coloured') urine 2 weeks after a streptococcal pharyngitis. Serum C3 is low and C4 is normal. ASO titre is elevated. What is the most likely diagnosis?

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Correct answer: B — Post-streptococcal glomerulonephritis (PSGN)

Post-streptococcal glomerulonephritis presents 1–3 weeks after streptococcal pharyngitis (or 3–6 weeks after skin infection) with nephritic syndrome: haematuria, oedema, hypertension, and renal impairment. Low C3 with normal C4 (activation of the alternative complement pathway) and elevated ASO titre are characteristic. C3 typically normalises within 8–12 weeks. Prognosis is excellent in children.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Glomerulonephritis