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Post-streptococcal glomerulonephritis — RACP Paediatrics MCQ

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ModerateNephrologyPost-streptococcal glomerulonephritisRACP Paediatrics

A 7-year-old presents with periorbital oedema, tea-coloured urine, and hypertension 2 weeks after impetigo. Urine shows red cell casts and moderate proteinuria. Serum C3 is low, C4 is normal. ASO titre is elevated. Creatinine is mildly elevated. What is the most likely diagnosis?

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Correct answer: D — Post-streptococcal glomerulonephritis

Nephritic syndrome (haematuria with red cell casts, hypertension, oedema, mild proteinuria, and renal impairment) occurring 1-3 weeks after streptococcal skin or throat infection with low C3, normal C4, and elevated ASO titre is classic post-streptococcal glomerulonephritis. Management is supportive. C3 should normalise within 8-12 weeks.

Reference: RCH Melbourne – 2023 – Glomerulonephritis CPG; RACP Paediatric Curriculum – Nephrology