Nephrology · NEET PG Preparation Medicine
A 28-year-old man presents with acute onset oliguria, gross hematuria, and severe hypertension 3 weeks after recovering from a skin infection. Labora…
Practice question from Nephrology (NEET PG Preparation Medicine), with the correct answer and a step-by-step solution.
medium · MCQ · Q-BF8133
A 28-year-old man presents with acute onset oliguria, gross hematuria, and severe hypertension 3 weeks after recovering from a skin infection. Laboratory tests reveal elevated anti-streptolysin O (ASO) titers and low serum C3 levels with normal C4 levels. Renal biopsy is performed. Which of the following immunofluorescence findings is most characteristic of this condition?
- A.Linear IgG deposition along the GBM
- B.Granular IgG and C3 deposition in a 'starry sky' or 'lumpy-bumpy' patternCorrect answer
- C.Dense intramembranous deposits
- D.Pauci-immune staining with minimal immune complex deposition
Solution
The patient has post-streptococcal glomerulonephritis (PSGN), characterized by low C3 (activation of the alternative pathway), high ASO titers (following impetigo or pharyngitis), and immune complex-mediated injury. On renal biopsy, immunofluorescence classically shows coarse granular IgG and C3 deposition along the glomerular basement membrane and in the mesangium, described as a 'lumpy-bumpy' or 'starry sky' pattern.
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