Gross hematuria, 3 days following an attack of UI in a young female is likely due to?
The two most common presentations of IgA nephropathy are recurrent episodes of macroscopic hematuria during or immediately following an upper respiratory infection often accompanied by proteinuria or persistent asymptomatic microscopic hematuria. So the most likely diagnosis in this patient is IgA nephropathy. IgA nephropathy is an immune complex-mediated glomerulonephritis defined by the presence of diffuse mesangial IgA deposits often associated with mesangial hypercellularity. A renal biopsy is necessary to confirm the diagnosis. There is no optimal treatment. Angiotensin-conveing enzyme (ACE) inhibitors are given in patients with proteinuria or declining renal function. Poststreptococcal glomerulonephritis due to impetigo develops 2-6 weeks after skin infection and 1-3 weeks after streptococcal pharyngitis. This rules out Poststreptococcal glomerulonephritis from the diagnosis in this case. Minimal change disease and Membranous Glomerulonephritis does not produce gross hematuria but instead microscopic hematuria. Ref: Harrison's Internal Medicine, 18th Edition, Pages 2342-2343, 2340, 2345, 2347
Post streptococcal glomerulonephritis
IgA nephropathy
Minimal change disease
Membranous glomerulonephritis