A 10-year-old boy develops facial puffiness, dark tea-colored urine, and hypertension 2 weeks after streptococcal pharyngitis. What renal biopsy finding on electron microscopy is expected?
Answer and explanation
Correct answer: A. Subepithelial immune complex humps
- Step 1: Nephritic syndrome occurring after pharyngeal streptococcal infection indicates post-streptococcal glomerulonephritis.
- Step 2: Electron microscopy characteristically demonstrates large dome-shaped subepithelial electron-dense humps representing immune complex deposition.
Answer
Subepithelial immune complex humps.
Why not the others: Thinning of the glomerular basement membrane is the diagnostic feature of benign familial hematuria or early Alport syndrome. Isolated podocyte foot process effacement without deposits is diagnostic of minimal change disease. Linear IgG deposition along the glomerular basement membrane characterizes anti-GBM disease (Goodpasture syndrome).
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