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December 14, 2021

Diagnose This (December 13, 2021)

post-infectious GN

This is the IgG IF of a biopsy from a 14yo boy with AKI and hematuria. What would you be your top differential? 

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The IF shows IgG staining in a “garland” pattern. There was also C3 in the same distribution and an exudative GN by light microscopy. He had a history of upper respiratory tract infection 2 weeks prior and low C3 levels. These findings would be consistent with post-infectious GN (PIGN). Recently, a subset of children with PIGN was found to have transient anti-factor B autoantibodies.

 

References

Anti-Factor B Antibodies and Acute Postinfectious GN in Children, https://pubmed.ncbi.nlm.nih.gov/32034108/