Postinfectious glomerulonephritis — ABIM Board MCQ

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ModerateNephrologyPostinfectious glomerulonephritisABIM Board

A 36-year-old develops edema, hypertension and tea-colored urine two weeks after streptococcal pharyngitis. C3 is low, antistreptolysin O is elevated and urine contains dysmorphic red cells and red-cell casts. Which diagnosis is most likely?

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Correct answer: A — Postinfectious glomerulonephritis

The best answer is “Postinfectious glomerulonephritis”. The latent interval after streptococcal infection, nephritic urine sediment and low complement support postinfectious glomerulonephritis. IgA nephropathy usually occurs concurrently with the mucosal infection and has normal complement; minimal-change and membranous disease produce nephrotic rather than nephritic presentations. The nephritic urine sediment confirms glomerular inflammation, while the depressed C3 supports complement-consuming postinfectious disease.

Reference: KDIGO 2021 Glomerular Diseases Guideline: https://kdigo.org/guidelines/gd/