IgA Nephropathy: The Daily PANCE Blueprint

Home IgA Nephropathy: The Daily PANCE Blueprint

IgA Nephropathy: The Daily PANCE Blueprint

A previously healthy 22-year-old man presents with one day of "Coca-Cola–colored" urine. The dark urine began the same day his sore throat and nasal congestion started, about 24 hours ago. He denies dysuria, flank pain, fever, rash, or joint pain. Vital signs are normal, including a blood pressure of 122/76 mm Hg, and he has no peripheral edema. Urinalysis shows 3+ blood with dysmorphic red cells and red cell casts; urine protein is mildly elevated. Serum creatinine is 1.0 mg/dL, and complement levels (C3 and C4) are normal. Which of the following is the most likely diagnosis?

A. IgA nephropathy (Berger disease)
B. Post-streptococcal glomerulonephritis
C. Alport syndrome
D. Thin basement membrane disease
E. Anti-GBM disease (Goodpasture syndrome)

Answer and topic summary

The answer is A. IgA nephropathy (Berger disease)

IgA nephropathy is the most common primary glomerulonephritis worldwide and classically presents in a young adult with gross hematuria occurring within 1–2 days of an upper respiratory infection (“synpharyngitic”). The hallmark discriminator is the normal complement (C3/C4), which separates it from post-infectious disease — that causes low C3 and follows a 1–3 week latent period. Urinalysis shows a glomerular pattern: dysmorphic RBCs and red cell casts. Per the KDIGO 2021 Glomerular Diseases guideline, diagnosis is confirmed by biopsy showing mesangial IgA deposits, and initial management is supportive care with maximally tolerated RAAS blockade (ACEi/ARB) and blood pressure control rather than first-line immunosuppression.

View blueprint lesson

Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Renal ⇒ Acute Disorders ⇒ Glomerulonephritis

Sign up for the ENTIRE Blueprint Daily Email Series (1000 daily questions. . . and counting! 😀)

Sign Up
X

Have you tried the NEW Smarty PANCE QBANK? It's FREE with EVERY membership purchase 😀!

Meet the new QBank! 👈
X