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Large, hypercellular glomeruli on light microscopy
63%
113/178
Polyclonal IgA deposition on immunofluorescence
9%
16/178
Immune complex deposits with a "spike and dome" appearance on electron microscopy
18%
32/178
Wirelooping and hyaline thrombi on light microscopy
4%
7/178
Antibodies to GBM resulting in a linear immunofluorescence pattern
3%
5/178
Select Answer to see Preferred Response
This patient's presentation and laboratory results are consistent with post-streptococcal (post-infectious) glomerulonephritis (PSGN). On light microscopy, PSGN will show large, hypercellular glomeruli with neutrophil infiltration. Post-streptococcal illnesses in children include acute rheumatic fever, pediatric autoimmune neuropsychiatric disorders, and post-streptococcal glomerulonephritis. PSGN results most commonly from skin infection (e.g. impetigo) and less commonly from pharyngitis, but can follow any viral or bacteria infection. The presentation is caused by antigen-antibody complex deposition on the glomerular membrane. Diagnosis involves decreased serum C3 level and an elevated anti-DNAse B titer. The urinalysis will show blood characteristic of glomerulonephritides. Incorrect Answers: Answer 2: Polyclonal IgA deposition on immunofluorescence is consistant with IgA glomerulonephritis. Answer 3: Immune complex deposits with a "spike and dome" appearance on electron microscopy is consistent with diffuse membranous glomerulopathy. Answer 4: Wirelooping and hyaline thrombi on light microscopy is consistent with diffuse proliferative glomerulonephritis. Answer 5: Antibodies to GBM resulting in a linear immunofluorescence pattern is consistant with Goodpasture disease.
3.8
(14)
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