DEFINITION

Is the sudden onset of

  • Gross hematuria
  • Oedema
  • Hypertension
  • Renal insufficiency

Most common cause of in children next is IgA nephropathy

AETIOLOGY-

Follows infection of the throat or skin (Group A b-hemolytic streptococci).

CLINICAL MANIFESTATIONS

  • Onset 1–2 wk after streptococcal infection.
  • Oedema
  • Hypertension
  • Oliguria.
  • Encephalopathy or heart failure due to hypertension
  • Nephrotic syndrome may occur.
  • Nonspecific symptoms such as malaise, lethargy, abdominal pain and fever

DIAGNOSIS.

  • Urine – look for red blood cells (RBCs), casts and proteinuria, Polymorphonuclear leukocytosis
  • Normochromic anaemia.
  • Low serum C3 level
  • Renal function tests
  • A throat culture may be positive
  • Elevated antibody titer to streptococcal antigen(s) – ASO titer
  • Streptozyme test – detects antibodies to streptolysin O, DNase B, hyaluronidase
  • Renal biopsy ordinarily is indicated.

COMPLICATIONS.

  • Heart failure
  • Hypertension
  • Hyperkalemia
  • Hyperphosphatemia/ Hypocalcemia
  • Acidosis/ Seizures
  • Uremia

PREVENTION.  

Family members of patients with acute glomerulonephritis should be cultured for group A b hemolytic streptococci and treated if culture positive.

TREATMENT.  

  • Management is that of acute renal failure
  • A 10-day course of systemic antibiotic – penicillin
  • Bed rest if there is a complication
  • Antihypertensive medications (diuretics, Angiotensin-converting enzyme inhibitors)

PROGNOSIS.

Complete recovery occurs in more than 95% of children

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