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Post-streptococcal glomerulonephritis — MRCPCH FOP MCQ

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HardRenalPost-streptococcal glomerulonephritisMRCPCH FOP

An 8-year-old boy has cola-coloured urine and facial puffiness two weeks after impetigo. Blood pressure is 132/86 mmHg, complement C3 is low and urine dipstick shows blood 3+ and protein 2+. What is the most likely diagnosis?

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Correct answer: E — Post-streptococcal glomerulonephritis

Haematuria, oedema, hypertension and low complement after streptococcal skin infection suggest post-streptococcal glomerulonephritis. Minimal change disease usually causes heavy proteinuria without prominent haematuria or low complement. UTI would not typically lower complement or cause this nephritic pattern. The pearl is that nephritic syndrome is defined by haematuria with hypertension and renal inflammation.

Reference: NICE CKS Glomerulonephritis; UK Kidney Association guidance