Differential Diagnosis for Anton's Case
The following differential diagnoses are organized into categories based on their likelihood and potential impact on the patient's health.
Single Most Likely Diagnosis
- Acute Post-Streptococcal Glomerulonephritis (APSGN): This diagnosis is strongly suggested by the recent history of sore throat, elevated Anti-streptolysin O (ASO) titer, hematuria, proteinuria, and the presence of RBC casts in the urine. The clinical presentation of periorbital and lower extremity edema, hypertension, and decreased urine output also supports this diagnosis.
Other Likely Diagnoses
- Nephrotic Syndrome: Although less likely given the presence of hematuria and RBC casts, nephrotic syndrome could explain the edema and proteinuria. However, the recent infection and elevated ASO titer make APSGN more probable.
- Acute Kidney Injury (AKI) from Other Causes: Other causes of AKI, such as medications or toxins, could also present with decreased urine output and elevated serum creatinine. However, the specific combination of symptoms and laboratory findings points more towards APSGN.
Do Not Miss Diagnoses
- Rapidly Progressive Glomerulonephritis (RPGN): Although less common, RPGN can present similarly to APSGN but with a more severe and rapid progression to kidney failure. It is crucial to monitor the patient's renal function closely.
- Vasculitis (e.g., Henoch-Schönlein Purpura): Vasculitis can cause similar symptoms, including renal involvement, but typically includes other systemic symptoms like abdominal pain and rash.
Rare Diagnoses
- Alport Syndrome: A genetic disorder that affects the type IV collagen in the kidneys, ears, and eyes, leading to hematuria and progressive kidney disease. It is less likely given the acute presentation and recent infection.
- Membranoproliferative Glomerulonephritis: A rare cause of kidney disease that can present with hematuria and proteinuria, but it is less likely given the clinical context and laboratory findings suggestive of a post-infectious glomerulonephritis.