Question

A child presented to the hospital with cola-colored urine, hypertension, and puffiness of eyes. Laboratory investigations were done, and creatinine was 2.5 mg/dL. Treatment was started, and despite treatment, the patient did not improve for the next 3 weeks. The creatinine value increased to 4.5 mg/dL. Which among the following electron microscopic findings will be seen in this patient ?

• A. Subendothelial deposits
• B. Subepithelial deposits
• C. Crescent formation
• D. Mesangial deposits

Answer 1

The Correct Option is B

The clinical presentation described in the question suggests the possibility of acute post-streptococcal glomerulonephritis (APSGN), particularly given the cola-colored urine (indicative of gross hematuria), hypertension, and edema (puffiness of eyes). APSGN typically occurs following an infection with group A beta-hemolytic streptococcus. Regarding the laboratory tests, the elevated creatinine levels (from 2.5 mg/dL to 4.5 mg/dL) indicate worsening renal function, which aligns with significant glomerular injury.

To determine the electron microscopic findings, we need to understand the characteristics of APSGN:

• APSGN characteristics: It is an immune complex-mediated disease where antigen-antibody complexes deposit in the glomeruli. Classically, APSGN is associated with subepithelial immune complex deposits, known as "humps," which can be identified using electron microscopy.

Characteristic Finding in APSGN	Subepithelial deposits

Thus, given this clinical scenario and the understanding of APSGN, the electron microscopic finding most likely seen in this patient is subepithelial deposits, aligning with the correct answer from the options provided.