A 32-year-old female presents with fatigue, decreased appetite, cola-colored urine, edema of the hands and feet, and elevated blood pressure following a recent sore throat. What is the most likely diagnosis?

• A. Nephrotic syndrome
• B. Post-streptococcal glomerulonephritis
• C. IgA nephropathy
• D. Hemorrhage cystitis

Answer: (B)

Post-streptococcal glomerulonephritis is an immune complex–mediated nephritic syndrome that can follow a streptococcal throat infection. The combination of cola-colored urine (hematuria), edema, and hypertension after a recent sore throat points to glomerular inflammation from immune complex deposition, typically occurring about 1–3 weeks after the pharyngitis. Lab clues include low C3 due to complement consumption and urine with red blood cell casts. This pattern fits best because it emphasizes a post-infectious nephritic process with hematuria and edema, unlike nephrotic syndrome (heavy proteinuria with hypoalbuminemia and minimal hematuria) or IgA nephropathy (hematuria that occurs concurrently with infection, often with normal complements), and it differs from hemorrhagic cystitis, which lacks the edema and hypertension pattern.