Question

Recurrent episodes of macroscopic hematuria during or immediately following an upper respiratory infection in a feature of:

• A. \( \text{Lupus nephritis} \)
• B. \( \text{IgA Nephropathy} \)
• C. \( \text{Minimal change disease} \)
• D. \( \text{Focal segmental glomerulosclerosis} \)

Hint:

\textbf{Nephrology: Glomerular Diseases.} Remember the key clinical features of common glomerular diseases. IgA nephropathy's hallmark is synpharyngitic hematuria, minimal change disease presents with nephrotic syndrome and minimal glomerular changes on light microscopy, and FSGS is characterized by focal and segmental sclerosis of glomeruli. Lupus nephritis occurs in the context of systemic lupus erythematosus.

Answer 1

The Correct Option is B

The clinical presentation of recurrent episodes of macroscopic hematuria (visible blood in the urine) that occur during or immediately following an upper respiratory infection (synpharyngitic hematuria) is a characteristic feature of IgA nephropathy, also known as Berger's disease. IgA nephropathy is a glomerular disease caused by the deposition of immunoglobulin A (IgA) in the glomeruli of the kidneys. The exact trigger for these IgA deposits is not fully understood, but infections, particularly of the upper respiratory tract or gastrointestinal tract, are known to exacerbate the condition and lead to episodes of macroscopic hematuria. The latent period between the infection and the onset of hematuria is typically short, often occurring concurrently or within a few days. Let's briefly look at why the other options are less likely: Lupus nephritis: This is kidney inflammation caused by systemic lupus erythematosus (SLE). While hematuria can be a feature, it is not typically associated with such a close temporal relationship to upper respiratory infections as seen in IgA nephropathy. Lupus nephritis usually presents with other systemic symptoms and signs of SLE. Minimal change disease: This is a common cause of nephrotic syndrome in children, characterized by proteinuria (protein in the urine), edema, hypoalbuminemia, and hyperlipidemia. Hematuria is usually microscopic or absent. It is not typically triggered by upper respiratory infections in the same way as IgA nephropathy. Focal segmental glomerulosclerosis (FSGS): This is a pattern of glomerular injury that can have various causes. It typically presents with proteinuria, and hematuria may be present but is not the predominant feature linked to upper respiratory infections. Therefore, the clinical scenario described is most consistent with IgA nephropathy.