What is the likely diagnosis for a child with post-streptococcal glomerulonephritis (PSGN) symptoms, including hypertension, impaired renal function, hematuria, and proteinuria?

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Differential Diagnosis for Anton

  • Single most likely diagnosis
    • Poststreptococcal glomerulonephritis (PSGN): This is the most likely diagnosis given the recent history of sore throat and fever, elevated ASO titer, and the presence of hematuria, proteinuria, and RBC casts in the urinalysis. The child's symptoms, including periorbital and lower extremity edema, decreased urine output, and dark-colored urine, are also consistent with PSGN.
  • Other Likely diagnoses
    • Nephrotic syndrome: Although less likely than PSGN, nephrotic syndrome could explain the edema, proteinuria, and low serum albumin. However, the presence of hematuria and RBC casts makes this diagnosis less likely.
    • Acute kidney injury (AKI): The child's decreased urine output, elevated serum creatinine, and dark-colored urine suggest AKI, which could be caused by various factors, including PSGN.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Rapidly progressive glomerulonephritis (RPGN): Although less common, RPGN is a serious condition that can lead to rapid deterioration of kidney function and requires prompt treatment. The presence of RBC casts and hematuria could suggest RPGN.
    • Hemolytic uremic syndrome (HUS): HUS is a rare but life-threatening condition that can cause AKI, hemolytic anemia, and thrombocytopenia. Although the child's symptoms do not strongly suggest HUS, it is essential to consider this diagnosis due to its potential severity.
  • Rare diagnoses
    • Alport syndrome: A rare genetic disorder that affects the type IV collagen in the kidneys, leading to hematuria, proteinuria, and progressive kidney disease. Although possible, this diagnosis is less likely given the child's acute presentation and recent history of sore throat.
    • Membranoproliferative glomerulonephritis (MPGN): A rare condition characterized by the deposition of immune complexes in the glomeruli, leading to hematuria, proteinuria, and kidney dysfunction. MPGN is less likely given the child's clinical presentation and laboratory results.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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