This patient presents with characteristic symptoms and findings of PSGN.

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PSGN is an acute reversible disease and is characterized by spontaneous recovery in the vast majority
of patients. The typical urinalysis has a urinary sediment that is nephritic in nature, dis playing
dysmorphic red blood cells, red cell casts, leukocytes, occasional leukocyte casts, and proteinuria.
However, fewer than 5% of patients will actually develop nephrotic-range proteinuria. The serum
creatinine is typically elevated in the range of 88 to 177 mol/L (1 to 2 mg/dL), and compliment levels
such as C3 and CH50 are typically depressed in 90%ofcases. The vast majority of patients will have
transienthypergammaglobulinemia as well as mixed cryoglobulinemia. Most patients will present
with gross hematuria, head ache, and generalized symptoms of anorexia, nausea, vomiting, and
malaise. Physical examination may reveal hypervolemia, edema, and hypertension. The edema
probably results from increased sodium retention due to the decrease in the GFR. Swelling of the
renal capsule can cause occasional flank or back pain. Diagnosis is made in 90% of patients with
circulating antibodies against streptococcal enzymes such as antistreptolysin O (ASO), anti-DNAse B,
and anti-streptokinase (ASKase). Electron microscopy often reveals the presence of electron-dense
immune deposits in the subendothelial, subepithe lial, and mesangial areas. More extensive
immunoglobulin deposition throughout the glo merular capillary wall is associated with a worse
prognosis.