Acute Post-Streptococcal Glomerulonephritis in Children A Review (original) (raw)
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Hypertensive encephalopathy secondary to acute post- streptococcal glomerulonephritis
Boletín médico del Hospital Infantil de México, 2009
Acute post-streptococcal glomerulonephritis (APSGN) is the leading cause of nephritic syndrome in children and has a broad spectrum of clinical presentation ranging from asymptomatic cases to acute renal failure and encephalopathy. Most cases are sporadic, although the disease may occur in epidemic form, mainly related to poor sanitary conditions. Hypertensive encephalopathy is a severe complication, but there is a good outcome with appropriate treatment. Case report: We describe the case of a previously healthy 10-year-old male with a history of pharyngitis 1 week before his arrival to the emergency room. He presented with altered consciousness, partial seizures, hypertension and hematuria.
Acute Kidney Injury and Atypical Features during Pediatric Poststreptococcal Glomerulonephritis
International Journal of Nephrology, 2016
The most common acute glomerulonephritis in children is poststreptococcal glomerulonephritis (PSGN) usually occurring between 3 and 12 years old. Hypertension and gross hematuria are common presenting symptoms. Most PSGN patients do not experience complications, but rapidly progressive glomerulonephritis and hypertensive encephalopathy have been reported. This paper reports 17 patients seen in 1 year for PSGN including 4 with atypical PSGN, at a pediatric tertiary care center. Seventeen children (11 males), mean age of 8 years, were analyzed. Ninety-four percent had elevated serum BUN levels and decreased GFR. Four of the hospitalized patients had complex presentations that included AKI along with positive ANA or ANCAs. Three patients required renal replacement therapy and two were thrombocytopenic. PSGN usually does not occur as a severe nephritis. Over the 12-month study period, 17 cases associated with low serum albumin in 53%, acute kidney injury in 94%, and thrombocytopenia in ...
Medical Science and Discovery
Objective: Acute post-streptococcal glomerulonephritis (APSGN) is the most studied immune-mediated glomerulonephritis, being caused by streptococcal infections such as pharyngotonsillitis or skin infections (impetigo, erysipelas). Globally it is the main form of glomerular suffering among pediatric patients, especially between the ages of 3 and 15, but in the developed countries, the incidence of this condition has decreased significantly in the last decades. The majority of the medical literature indicates that the treatment in such a disease is symptomatic (the major goal being controlling of the edema and hypertension) associated with antibiotics for streptococcal infection. Due to some situations where antibiotic treatment cannot be administered, this case report hypothesized that homeopathy is a possible alternative treatment method for conventional therapy. We presented two cases diagnosed with APSGN: a nine-year-old boy treated homeopathically at home and a three-year-old gir...
Overview on Acute Poststreptococcal Glomerulonephritis in Pediatrics: A Review
Journal of Pharmaceutical Research International, 2021
Acute poststreptococcal glomerulonephritis (APSGN) is the most common kind of post-infectious glomerulonephritis and is caused by group A streptococcus (Streptococcus pyogenes). Although the prevalence of PSGN has decreased in affluent nations, non-streptococcal species are becoming more common. and it is still the major cause of glomerulonephritis in children. APSGN can manifest itself in epidemic outbreaks or clusters of instances, as well as in single persons. Epidemic outbreaks have previously been documented as a result of upper respiratory or cutaneous streptococcal infections in various parts of the world. In developed nations, APSGN is now mostly a disease of the elderly, who are more likely to have disabling illnesses such as cancer, alcoholism, or diabetes. Children between the ages of 3 and 12 (with a peak incidence between the ages of 5 and 6 years) and seniors over the age of 60 are the most commonly affected. The pathophysiology of APSGN is complicated by inflammation....
A Cluster of Cases of Acute Poststreptococcal Glomerulonephritis in a Family
Chattagram Maa-O-Shishu Hospital Medical College Journal, 2014
Acute post streptococcal glomerulonephritis (APSGN) remains a common cause of acute nephritis in children. Acute poststreptococcal glomerulonephritis usually occurs as sporadic cases, occasionally an unusually high incidence of acute nephritis has been recorded. In our country we need to recognize, document and analyze epidemic attacks of acute post streptococcal glomerulonephritis. Then we can plan for its prevention. We have reported here a cluster of cases of APSGN prevailed in a family of a rural setting of southeast part of Bangladesh which was admitted in a subdistrict level hospital and also noticed that total admitted cases of APSGN in that hospital was more during the month of notification in comparison to other months but were not able to identify all the cases of APSGN prevailing in that area. Prophylactic antibiotic treatment is advisable in epidemic conditions and to household contacts of index cases in communities where the prevalence of the disease is high. It is ex...
Outcome of severe acute post-streptococcal glomerulonephritis in New Zealand children
Pediatric Nephrology, 2008
Post-streptococcal glomerulonephritis (PSGN) is the commonest cause of severe acute glomerulonephritis in New Zealand children, with the majority (85%) of the patients being of either Pacific Island or Maori ethnicity. We have performed a retrospective study on 27 pediatric patients with acute PSGN. Of these patients, those with crescentic glomerulonephritis (n=11) had a greater tendency (72.7%) for needing acute dialysis and were left with persistent urinary sediment abnormalities after a mean follow-up of 3.2 years (95% confidence interval 2.1-4.3). The efficacy of immunosuppression in the group with crescentic disease was uncertain. The severity of renal histopathological abnormalities as judged by the total biopsy score did not correlate with either presentation or eventual outcome. Severe childhood acute post-streptococcal glomerulonephritis, although uncommon, results in significant long-term renal morbidity, particularly among Maori and Pacific Island children.
Clinical Profile and Short-Term Outcome of Acute Nephritic Syndrome in Children
Journal of Evolution of Medical and Dental Sciences, 2017
BACKGROUND Glomerulonephritis generally presents as a constellation of findings that includes haematuria, proteinuria and oedema. Poststreptococcal glomerulonephritis is the commonest form of acute glomerulonephritis in developing countries. Objectives-1. To study the clinical profile of acute glomerulonephritis. 2. To study the different clinical laboratory parameters at admission and at 8 weeks of onset of illness. MATERIAL AND METHODS This is a prospective, descriptive study conducted in a tertiary care teaching hospital in South India from January 2016-December 2016. Data regarding the clinical features, laboratory parameters, treatment were collected. All these patients were further followed up at 8 weeks and descriptive analysis done. RESULTS The most common cause of glomerulonephritis in the study group was poststreptococcal glomerulonephritis (42.9%) followed by drug-induced nephropathy (28.6%). The most common complaints were haematuria, facial puffiness, decreased urine output and oedema. Hypertension was found only in 14.3% of study group. 4.8% of patients had nephrotic range of proteinuria. The most common infection preceding was Pyoderma (61.5%) in case of PSGN. High ASO titre was seen commonly with pharyngitis. 45.2% patients had decreased Serum C3 at diagnosis. All the patients were treated conservatively. At 8 weeks followup, haematuria was persisting in 28.6% patients. Only 2 patients had persistently low serum C3 and single patient had high creatinine. CONCLUSION Post-streptococcal glomerulonephritis is still the most common cause of glomerulonephritis in children followed by drug-induced nephropathy. The changing epidemiology needs to be followed up regarding the need for NSAID use and guidelines to restrict its use in any form to absolute indications only.
The American Journal of Medicine, 1979
Continued improvement was noted among 722 patients in Trinidad seven to 12 years after the anset of poststreptococcal glomerulonephritis. In the five years since earlier follow-up, two of 709 patients with previous symptomatic disease apparently had died from renal failure, and 10 patients had died from unrelated causes. Nineteen patients presently had proteinuria, three had hematuria, and three had proteinuria plus hematuria. Of these abnormalities, protein&as in only three patients and proteinuria plus hematurias in three more patients were persistent. Thus, 0.8 per cent of the study group had persistent abnormalities. When one adds those dead with renal disease, the percentage with renal damage becomes 1.1 per cent. In addition, six patients had protein in the two urine samples obtained after assuming the lordotic position for 10 minutes and in only one of the two urine samples obtained upon rising in the morning, making 1.4 per cent with probable evidence of chronic renal disease, including the dead patients. Hypertension was present in 16 (2.3 per cent) of the patients and was much more common in those more than 20 years old (18.4 per cent). However, this prevalence of hypertension did not exceed that found in normal Trinidadians. Only three patients had serum creatinine values greater than 1.2 mg/dl. None of 13 patients with previous asymptomatic glomerulonephritis presently showed any abnormality.