Question:medium
A 51-year-old person came with a complaint of hematuria. On examination he was normotensive and had pedal edema. Investigations revealed the patient had no glucosuria and had a creatinine value of 9 mg%. The renal biopsy is as shown below. Which of the following investigations should one do to identify the etiology of the disease?
A 51-year-old person came with a complaint of hematuria. On examination he was normotensive and had pedal edema. Investigations revealed the patient had no glucosuria and had a creatinine value of 9 mg%. The renal biopsy is as shown below. Which of the following investigations should one do to identify the etiology of the disease?
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Linear IgG along the basement membrane on immunofluorescence has one signature antibody.
Updated On: Jun 23, 2026
- ANA
- Anti-GBM antibodies
- HIV RNA
- Urine immunoelectrophoresis
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The Correct Option is B
Solution and Explanation
Pattern-recognition first: on renal immunofluorescence there are three deposit patterns. Linear means anti-GBM (Goodpasture), granular means immune-complex disease (lupus, post-infectious), and pauci-immune means ANCA vasculitis. The biopsy here shows smooth linear IgG, so the diagnosis is anti-GBM disease.
The clinical story fits: a nephritic syndrome with hematuria, edema and a creatinine of $9$ mg% reflecting aggressive glomerular damage. To confirm the cause, the single most useful test is the serum assay for $anti$-$GBM$ antibodies, which directly identifies the autoantibody driving the disease.
Eliminating the rest: ANA chases lupus, urine immunoelectrophoresis chases myeloma light chains, and HIV RNA chases HIV nephropathy, but none of these explain a linear IgG biopsy. The answer is option (b), anti-GBM antibodies.
The clinical story fits: a nephritic syndrome with hematuria, edema and a creatinine of $9$ mg% reflecting aggressive glomerular damage. To confirm the cause, the single most useful test is the serum assay for $anti$-$GBM$ antibodies, which directly identifies the autoantibody driving the disease.
Eliminating the rest: ANA chases lupus, urine immunoelectrophoresis chases myeloma light chains, and HIV RNA chases HIV nephropathy, but none of these explain a linear IgG biopsy. The answer is option (b), anti-GBM antibodies.
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