IgA Nephropathy vs Post-Streptococcal Glomerulonephritis
IgA Nephropathy and Post-Streptococcal Glomerulonephritis are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.
IgA Nephropathy vs Post-Streptococcal Glomerulonephritis at a glance
- IgA Nephropathy: Most common primary glomerulonephritis; mesangial IgA deposits with synpharyngitic hematuria.
- Post-Streptococcal Glomerulonephritis: Immune complex GN 1-3 weeks after group A strep pharyngitis or impetigo.
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Side-by-side comparison
| Feature | IgA Nephropathy | Post-Streptococcal Glomerulonephritis |
|---|---|---|
| At a glance | Most common primary glomerulonephritis; mesangial IgA deposits with synpharyngitic hematuria. | Immune complex GN 1-3 weeks after group A strep pharyngitis or impetigo. |
| Classic presentation | Recurrent episodes of cola-colored urine within 24-72 hours of a URI = synpharyngitic hematuria of IgA nephropathy.; Gross hematuria within 1-3 days of URI,… | Cola-colored urine + periorbital edema + hypertension in a child 1-3 weeks after sore throat or impetigo = classic PSGN.; Abrupt onset of tea-colored or… |
| Workup / key labs | Definitive diagnosis requires kidney biopsy showing dominant or co-dominant mesangial IgA deposition on immunofluorescence with mesangial proliferation on… | Clinical diagnosis: nephritic syndrome + recent strep infection + low C3 + positive streptococcal serology. Biopsy reserved for atypical presentations… |
| Imaging | Renal ultrasound to assess size and exclude obstruction in presence of gross hematuria | Renal ultrasound usually unnecessary; normal or mildly enlarged kidneys |
| First-line treatment | BP control with ACEi (lisinopril, ramipril) or ARB (losartan, valsartan) — first-line; titrate to maximally tolerated dose; SGLT2 inhibitor — dapagliflozin or… | Supportive care — most cases resolve spontaneously; Sodium and fluid restriction for volume overload; Loop diuretic — furosemide — for edema and hypertension;… |
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