Q. A 16-year-old male presents to your clinic with complaints of painless hematuria. The patient reports the symptoms began one week ago. He denies any fevers, rashes, or lesions. There is no known history of trauma. His past medical history is unremarkable, and his immunizations are up to date. On physical exam, his blood pressure is 140/95 mm Hg, heart rate 70/min, respiratory rate 18/min, and oxygen saturation is 99 percent on room air. Visual acuity testing on a standard Snellen chart demonstrates 20/40 bilaterally. His cardiopulmonary examination is within normal limits. Abdominal assessment is normal, with no masses or organomegaly appreciated. No abnormalities are detected on examination of his external genitalia. You order a urinalysis which reveals hematuria and proteinuria, and urine microscopy shows the presence of red blood cell casts and acanthocytes. You refer the patient to a nephrologist and a subsequent renal biopsy finds focal and segmental glomerulosclerosis, tubular atrophy, interstitial fibrosis, and the presence of lymphocytes and plasma cells. Immunofluorescence studies yield negative results. Electron microscopy of the kidney reveals longitudinal splitting and multi-lamellation of the glomerular basement membrane lamina densa. Notably, monoclonal antibodies against alpha-3, alpha-4, and alpha-5 chains of type IV collagen are negative. Based on the information you have at this point in time, which of the following is NOT associated with his diagnosis?