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Post-streptococcal glomerulonephritis — RACP Paediatrics MCQ

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ModerateRenalPost-streptococcal glomerulonephritisRACP Paediatrics

An 8-year-old develops cola-coloured urine and periorbital oedema two weeks after impetigo. Blood pressure is 142/92 mmHg, urine has blood and protein, C3 is low and creatinine is mildly elevated. What is the most likely diagnosis?

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Correct answer: B — Post-streptococcal glomerulonephritis

Haematuria, oedema, hypertension and low complement after streptococcal skin infection are classic for post-streptococcal glomerulonephritis. Minimal change nephrotic syndrome causes heavy proteinuria and oedema but not usually cola urine, low C3 and hypertension. The pearl is that fluid status and blood pressure management are central in the acute phase.

Reference: RCH Clinical Practice Guidelines: Acute post-streptococcal glomerulonephritis; Therapeutic Guidelines (eTG)