Acute post-streptococcal glomerulonephritis in an 8-month-old girl

Volti, S. Li; Furnari, Maria Luisa; Garozzo, Rosaria; Santangelo, Gaetano; Mollica, F

doi:10.1007/bf01213338

Cited by 10 publications

(6 citation statements)

References 8 publications

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“…The incidence of APSGN ranges from 30-300 per million population per year, with most of these occurring in children over 2 years of age [3,4]. From our review of the literature, there have been only four reports of APSGN in children <2; the youngest was 8 months of age [5]. There appear to be two reasons that APSGN is rare in children <2: (1) the infrequency of GAS pharyngitis and (2) impaired immunogenicity.…”

Section: Discussionmentioning

confidence: 95%

Acute post-streptococcal glomerulonephritis in a 14-month-old boy: why is this uncommon?

2007

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Acute post-streptococcal glomerulonephritis (APSGN) is rare in children under 2 years of age. This is related in part to the disease patterns of group A streptococcus (GAS) and in part to impaired immunogenicity in infants. We report the case of a 14-month-old child with APSGN following GAS pharyngitis. This case illustrates that APSGN needs to be considered in the evaluation of both gross and microscopic hematuria in this age group. We review the literature of both GAS and APSGN and discuss the pathogenesis and epidemiologic reasons for this association.

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Section: Discussionmentioning

confidence: 95%

Acute post-streptococcal glomerulonephritis in a 14-month-old boy: why is this uncommon?

2007

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“…The median age at presentation for PSAGN in childhood is between 6 and 8 years old [126,128,129]; the condition rarely occurs prior to age 2 [126,130,131]. The rarity of PSAGN in very young children was attributed to the low rate of streptococcal pharyngitis in this age group and an immature immune (or antibody) response [130].…”

Section: Clinical Manifestations-typical Course Atypical Featuresmentioning

confidence: 99%

“…The rarity of PSAGN in very young children was attributed to the low rate of streptococcal pharyngitis in this age group and an immature immune (or antibody) response [130]. Twice as many males are diagnosed with PSAGN as females [126,130,131]; the reason for this is unknown. There appears to be no difference in gender ratio whether PSAGN follows pharyngitis or pyoderma.…”

Section: Clinical Manifestations-typical Course Atypical Featuresmentioning

confidence: 99%

Post-streptococcal acute glomerulonephritis in children: clinical features and pathogenesis

et al. 2010

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Post-streptococcal acute glomerulonephritis (PSAGN) is one of the most important and intriguing conditions in the discipline of pediatric nephrology. Although the eventual outcome is excellent in most cases, PSAGN remains an important cause of acute renal failure and hospitalization for children in both developed and underdeveloped areas. The purpose of this review is to describe both the typical and less common clinical features of PSAGN, to outline the changes in the epidemiology of PSAGN over the past 50 years, and to explore studies on the pathogenesis of the condition with an emphasis on the search for the elusive nephritogenic antigen.

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“…The risk of APSGN in case of infection caused by nephritogenic GAS reaches 15% [3]. Different types of S. pyogenes cause APSGN followed by pharyngitis, tonsillitis or scarlet fever (types 1, 2, 3,4,6,12,18,19,24,25,31,49) and other types followed skin infection such as roseola or impetigo (types 49, 55, 56, 57, 60) [2,3,5,8].…”

Section: Discussionmentioning

confidence: 99%

“…Literature data indicate a twofold higher incidence of APSGN in boys [11]. Although the disease can occur at any age, including in adults (about 10% of cases), it is rarely found in children younger than three years of age, with only isolated reports of patients in the 1 st year of life [12]. The smaller pore size in the glomerular basement membrane (GBM) in children, which hinders the renal removal of immune complexes, may be responsible for the higher incidence of APSGN in the pediatric population.…”

Section: Discussionmentioning

confidence: 99%

Acute post-streptococcal glomerulonephritis – immune-mediated acute kidney injury – case report and literature review

Skrzypczyk¹,

Ofiara²,

Zacharzewska³

et al. 2021

cejoi

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Acute post-streptococcal glomerulonephritis (APSGN) is an immunological complication of infection with group A β-hemolytic streptococcus (GAS). The disease manifests as microscopic or gross hematuria, arterial hypertension, edema, and acute kidney injury and has most commonly a self-limiting course. We report a very severe case of APSGN in a 5-year-old girl with superimposed generalized infection. The girl presented significant overhydration, a very low glomerular filtration rate (GFR) (11.2 ml/min/1.73 m 2 ), hyperuricemia (12.7 mg/dl), nephrotic proteinuria, and gross hematuria. Her immunological tests allowed for the diagnosis of APSGN (elevated antistreptolysin O [ASO] titer, low C3, and normal C4 complement factors). She also showed very high inflammatory indicators suggestive of sepsis. She received supportive treatment together with ceftriaxone and a single dose of rasburicase. Her renal function recovered, and urinalysis normalized. Gallbladder deposits complicated the treatment. This article summarizes the existing knowledge on APSGN with particular emphasis on the immunological mechanisms of the disease. The proposed immunological pathway leading to glomerular injury is discussed. In children, APSGN has an excellent prognosis, including in cases with severe renal impairment in the early stages of the disease.

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Acute post-streptococcal glomerulonephritis in an 8-month-old girl

Abstract: We describe a middle class Sicilian girl who at 8 months of age suffered acute post-streptococcal glomerulonephritis documented by clinical hist a positive type 12 beta-haemolytic streptococcus throat culture, a raised anti-sterptolysin O titre and a low C3 rising to normal after 8 weeks

Cited by 10 publications

References 8 publications

Acute post-streptococcal glomerulonephritis in a 14-month-old boy: why is this uncommon?

Acute post-streptococcal glomerulonephritis in a 14-month-old boy: why is this uncommon?

Post-streptococcal acute glomerulonephritis in children: clinical features and pathogenesis

Acute post-streptococcal glomerulonephritis – immune-mediated acute kidney injury – case report and literature review

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