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IgA Nephropathy — RACP Paediatrics MCQ

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ModerateNephrologyIgA NephropathyRACP Paediatrics

A 3-year-old child presents with painless gross haematuria. He is well with normal blood pressure. Urine microscopy shows dysmorphic red blood cells and red cell casts. C3 and C4 are normal. Renal function is normal. IgA level is elevated. What is the most likely diagnosis?

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Correct answer: A — IgA nephropathy (Berger disease)

IgA nephropathy: the most common glomerulonephritis worldwide. Presents with episodic gross haematuria (often concurrent with URTI - 'synpharyngitic'), dysmorphic RBCs with casts (glomerular origin), normal complement, and elevated serum IgA. Diagnosis is confirmed by renal biopsy showing mesangial IgA deposits.

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