12 years old Shyam presented with gross hematuria with elevated serum immunoglobulin A. 2 days before he had mild upper respiratory tract infection. Diagnosis is:
High-Yield Explanation
When asymptomatic gross hematuria appears to accompany a minor acute febrile illness or other stressful occurrence, the diagnosis of IgA nephropathy may be enteained. In contrast to postinfection GN, IgA nephropathy is not associated with prior streptococcal infection, complement is not depressed, and in 50% of cases, serum immunoglobin A is elevated. Often there are no associated symptoms or signs. Gross hematuria resolves within days, and there are no serious sequelae in 85% of cases. Treatment is not indicated, and the prognosis is good in most cases. Ref: Lum G.M. (2012). Chapter 24. Kidney & Urinary Tract. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e.