Post-Streptococcal Glomerulonephritis: Histopathologic and Clinical Studies of the Acute, Subsiding Acute and Early Chronic Latent Phases*†

Jennings, Robert B.; Earle, David P.

doi:10.1172/jci104382

Cited by 152 publications

(27 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In some instances, the precipitate was solubilized in 0.05 N NaOH in order to obtain a spectrophotometer reading. The optical density was 0.995. increasing streptococcal antibody titers in patients with acute glomerulonephritis following the initial phase of the disease (24,25).…”

Section: Discussionmentioning

confidence: 99%

Partial characterization of antigenic streptococcal plasma membrane components in acute glomerulonephritis

Treser¹,

Semar²,

Ty³

et al. 1970

J. Clin. Invest.

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Partial characterization of antigenic streptococcal plasma membrane components in acute glomerulonephritis

Treser¹,

Semar²,

Ty³

et al. 1970

J. Clin. Invest.

View full text Add to dashboard Cite

“…Renal biopsies in 8 elderly patients (older than 60 years of age) with PSGN showed prolifer ative and exudative glomerular changes in all cases, with 3 showing crescent formation (involving less than 20% of glomeruli) [3,4,20], Though PSGN is a rare cause of crescentic glomerulonephritis [39,40], our patient was found to have epithelial crescents in more than 60% of glomeruli. The presence of a large number of crescents indicates the likelihood of a rapid progression to renal failure and a poor prognosis for recovery [14,34], Our patient also had the unusual pathologic finding of a large number of polymorphs in the renal tubules.…”

Section: Discussionmentioning

confidence: 81%

“…In general, it appears that the prognosis for adults is less favorable than that for children [28,34], Death in the acute stage is uncom mon, but adult patients appear to have persistent or pro gressive renal dysfunction more frequently. In the report by Jennings and Earle [3], one-third of the patients showed incomplete resolution on renal biopsy after short-term follow-up. Baldwin et al [28] reported that 30-40% of their patients had some clinical evidence of persistent renal disease when followed 5 or more years.…”

Section: Discussionmentioning

confidence: 94%

“…Kushner et al [2] reported 45 cases of acute nephritis in adults and the oldest patient was 52 years of age. In another report of 36 patients of all age groups with spo radic PSGN, only 1 patient was older than 60 years of age [3], Arieff et al [4] reviewed 70 cases of acute glo merulonephritis in patients 50 years of age and older and found that 11 (16%) had a streptococcal etiology. Several other authors have reviewed acute glomerulonephritis in the elderly, though these reports contain cases of varying and uncertain etiologies [5][6][7][8].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Poststreptococcal Glomerulonephritis in the Elderly

Melby¹,

Musick²,

Luger³

et al. 1987

Am J Nephrol

View full text Add to dashboard Cite

Acute poststreptococcal glomerulonephritis (PSGN) is uncommonly seen in the elderly population and its diagnosis is not without some difficulty because clinical manifestations may mimic other diseases. Renal biopsy for diagnosis and early intervention, if indicated, is very valuable in such a situation. We present here a case of an elderly patient with PSGN and a review of the literature. In addition to the typical clinical manifestations of the disease, dyspnea and pulmonary congestion are commonly present in elderly patients, probably a result of excessive salt and water retention in the face of compromised cardiovascular function. Elderly patients with PSGN appear to have a remarkably poor prognosis, with significant incidences of acute mortality and chronic renal disease. Our patient had the unusual finding of a large number of glomerular crescents with near complete clinical recovery after short-term follow-up.

show abstract

“…Baldwin (1977) found proteinuria to be absent in 1% of 174 attacks of PSGN in 168 subjects, while Jennings & Earle (1961) found one such case amongst 36 cases of PSGN. Another important clinical variant is presentation of PSGN as hypertensive encephalopathy with minimal urinary abnormalities (Hoyer et al 1967).…”

Section: Discussionmentioning

confidence: 98%

Acute Post-Streptococcal Glomerulonephritis without Proteinuria

et al. 1985

View full text Add to dashboard Cite

Summary: Two cases of histologically proven acute post-streptococcal glomerulonephritis presenting as congestive cardiac failure with normal blood pressure are reported. Proteinuria was not a finding. These features are discussed. Introduction The clinical hallmarks of acute nephritis are the abrupt onset of haematuria and proteinuria, accompanied by oliguria with oedema and hypertension. Recently we have seen a young woman with serologically and histologically proven acute post-streptococcal glomerulonephritis (PSGN) who had no proteinuria throughout her illness. Review of the records of 25 cases of biopsy-proven post-infectious glomerulonephritis presenting to the Department of Nephrology of the Royal Melbourne Hospital over 20 years revealed one similar case. Both cases are reported.Case reports Case 1: A 36-year-old woman suffered an influenza-like illness with high fever. Three days later she developed a reddish rash on the lower legs which settled over 48 hours. Over the next week she had aching in the wrists, ankles, knees and neck. For four days prior to admission she had severe headache and anorexia, and developed marked oedema of the face, arms and legs, associated with increased thirst and decrease in urine volume, which was not altered in colour.On examination, blood pressure was 125/80 mmHg, temperature 37.3°C, and weight was 9 kg above normal. The jugular venous pressure (JVP) was elevated; there was a fourth heart sound, ascites and oedema to the mid-thigh. Repeated routine urine dipstick testing showed no protein and a trace to one plus of blood; urine specific gravity was 1002.The chest X-ray showed interstitial pulmonary oedema with a normal heart size. ECG and echocardiogram were normal. Serum sodium was 129 mmol/l, potassium 5.0 mmol/l, albumin 39 g/l, creatinine 0.09 mmol/l and urea 9.1 mmol/l. A 24-hour urine collection of 1098 ml contained 46 mmol potassium, 33 mmol sodium, 0.04 g protein (normal <0.15 g) and the glomerular filtration rate using the 5tCr EDTA method was 66 ml/mm/1.73 m2 (normal 92-157). Urine microscopy showed 8000 leukocytes (WBC), 60 000 glomerular red cells (RBC) Fairley & Birch 1982) 12 000 hyaline and 20 000 red cell casts per ml. The haemoglobin was 10.0 g/dl, ESR 35 mm/h, and anti-DNase and antistreptolysin-o (ASO) titres of 1:360 suggested recent beta-haemolytic streptococcal infection. Immune complexes, autoantibodies, and hepatitis B antigen were negative and anti-DNA binding was normal. Both total complement and C3 were consistently depressed.Renal biopsy showed a diffuse proliferative and exudative endocapillary glomerulonephritis with mesangial and capillary loop staining for IgG, IgM, IgA, C3, Clq and fibrin on immunofluorescence.The oedema responded to bed rest, modest fluid restriction and oral frusemide. At no stage was the blood pressure elevated and the maximum urinary protein excretion was 0.20 g/day.Case 2: A 20-year-old woman presented with acute pulmonary oedema four weeks after a sore throat. Swelling of the feet, hands and face developed suddenly o...

show abstract

Post-Streptococcal Glomerulonephritis: Histopathologic and Clinical Studies of the Acute, Subsiding Acute and Early Chronic Latent Phases*†

Cited by 152 publications

References 26 publications

Partial characterization of antigenic streptococcal plasma membrane components in acute glomerulonephritis

Partial characterization of antigenic streptococcal plasma membrane components in acute glomerulonephritis

Poststreptococcal Glomerulonephritis in the Elderly

Acute Post-Streptococcal Glomerulonephritis without Proteinuria

Contact Info

Product

Resources

About