A 7-year-old boy presents with gross hematuria ('tea-colored' or 'coca-cola' urine), periorbital edema, and hypertension. His mother reports that he had a severe sore throat 2 weeks ago that resolved without treatment. Laboratory testing confirms low serum C3 complement and elevated anti-streptolysin O (ASO) titers. What is the most likely diagnosis?

Answer and explanation

Correct answer: C. Post-streptococcal glomerulonephritis (PSGN)

  1. Step 1: Analyze nephritic presentation: Hematuria, hypertension, edema, hypocomplementemia (low C3), and high ASO titers following a 1-2 week pharyngeal latent period.
  2. Step 2: This confirms Acute Post-Streptococcal Glomerulonephritis (PSGN), an immune-complex mediated nephritic syndrome.
Answer
Post-streptococcal glomerulonephritis (PSGN).
Why not the others: 'Minimal change disease' is a nephrotic syndrome presenting with heavy proteinuria, profound hypoalbuminemia, and normal complement levels; 'IgA nephropathy' develops hematuria concurrently with pharyngitis (synpharyngitic, within 1-2 days) without low complement; 'Alport syndrome' is an X-linked sensorineural hearing and renal basement membrane disorder.

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