Acute Glomerulonephritis in Children

Unusual Case of Post-Infection Nephritis Associated with Nephrin Mutation

“…The clinical presentation and responsiveness to treatment of glomerulonephritis can differ even in patients with the same histological lesion [3]. Poststreptococcal glomerulonephritis (PSGN) usually presents with gross hematuria, edema, hypertension and proteinuria [4,5]. It is estimated that 404,000 cases of PSGN occur annually in children younger than 15 years old, with approximately 97% in developed countries [6].…”

Acute Post-Streptococcal Glomerulonephritis in Children

“…Она обычно наиболее выражена в дебюте болезни, а в период увеличения диуреза посте-пенно cнижается, и артериальное давление нормали-зуется [20].…”

“…При этом отмечаются головная боль, рвота, расстройство зрения с возможным развитием потери сознания и судорог [20].…”

Atypical Clinical Manifestations of Acute Poststreptococcal Glomerulonephritis

“…Ramberg first mentioned this condition and reported eleven patients with the recurrent attacks out of 152 patients with APSGN (Ramberg, 1947). Thereafter, several clinical studies of APSGN have suggested an incidence of recurrent APSGN that ranges from 0.7% to 7.0% (Baldwin D et al, 1974;Bernstein et al, 1960;Dodge W. et al, 1968;Sanjad et al, 1977;Roy et al, 1969). In addition, a few case reports of recurrent APSGN have been described (Casquero et al, 2006;Derakhshan 2002;Kim et al, 1979;Rosenberg et al, 1984;Velhote et al, 1986;Watanabe & Yoshizawa, 2001).…”

“…Sanjad et al, 1977); an absence of natural immune responses against nephritogenic streptococcal components without antibiotic therapy (Watanabe & Yoshizawa, 2001), and; a failure to exclude microbial agents through the digestive and respiratory tract due to IgA deficiency (Casquero et al, 2006). Sanjado et al suggested that reinfection with the same type of Streptococcus would occur if the patient lacked antibodies against that particular type, and penicillin therapy given in the first ten days after a streptococcal infection suppressed the formation of type-specific immunity conferring antibodies, which might increase the chances of re-infection with the same nephritogenic strain responsible for the initial episode of APSGN (Sanjad et al, 1977). Recently, Yoshizawa et al identified a new nephritogenic streptococcal antigen and termed it nephritis-associated plasmin receptor (NAPlr) (Yamakami et al, 2000;Yoshizawa et al, 2004).…”