An asymptomatic patient has proteinuria and hematuria that is glomerular in origin on a routine urinalysis. Which of the following is the most likely diagnosis?
Correct Answer: immunoglobulin A (IgA) nephropathy (Berger's disease)
Description: Other causes of asymptomatic hematuria, with or without proteinuria, include sickle cell disease, Alport's syndrome, resolving glomerulonephritis, and thin basement disease. Berger's disease is characterized by immunoglobulin A (IgA) deposits in the mesangium. It most commonly affects older children and young adults, and is more common in Blacks than Whites. Macroscopic hematuria may occur with inter-current illness or vigorous exercise. The prognosis is variable but tends to progress slowly. Spontaneous remissions are more common in children than in adults. About 20-50% of patients develop end-stage renal disease within 20 years of diagnosis.
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