The Relevance between Renal Ultrasonographic Findings and Disease Course in Two Poststreptococcal Glomerulonephritis (PSGN) Patients

Lee, Jin Hee; An, Yu Kyung; Yoo, Ha Yeong; Kwak, Byung Ok; Park, Hye Won; Lim, So Dug; Son, Jae Sung; Chung, So Chung; Kim, Kyo Sun

doi:10.3339/chikd.2015.19.2.184

Cited by 2 publications

(3 citation statements)

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“…Kidney ultrasounds were performed in 36 (37.5%) children, even though this is not a routine investigation for APSGN. Increased parenchymal echogenicity was reported in 50% of the studies, which is consistent with a diagnosis of ‘medical renal disease’ 21,22 …”

Section: Resultssupporting

confidence: 60%

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Clinical characteristics of hospitalised children with acute post‐streptococcal glomerulonephritis in the Top End of Australia

Chong

Hung

Hohls

et al. 2023

J Paediatrics Child Health

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Aims Despite the declining incidence of acute post‐streptococcal glomerulonephritis (APSGN) in Australia, there is still a significant burden of disease amongst Aboriginal and Torres Strait Islander people in the Northern Territory. Childhood APSGN has been highlighted as a predictor of chronic kidney disease in this population. We aimed to describe clinical characteristics and outcomes of hospitalised children with APSGN in the Northern Territory. Methods Single‐centre, retrospective cohort study of children (<18 years) with APSGN admitted to a tertiary hospital in the Top End of the Northern Territory between January 2012 and December 2017. Cases were confirmed using the Centre for Disease Control case definition guidelines. Data were extracted from the case notes and electronic medical records. Results There were 96 cases of APSGN with median age of 7.1 years (interquartile range (IQR) 6.7–11.4). Majority were Aboriginal and Torres Strait Islander (90.6%) and from rural and remote areas (82.3%). Preceding skin infections were identified in 65.5% and sore throat in 27.1%. Severe complications included hypertensive emergencies (37.4%), acute kidney injury (43.8%) and nephrotic‐range proteinuria (57.7%). All children improved from their acute illness with supportive medical therapy; however, only 55 out of 96 (57.3%) children were followed up within 12 months of their acute illness. Conclusions APSGN disproportionately affects Aboriginal and Torres Strait Islander children and highlights the need for continued and improved public health response. There is room for significant improvement in the medium‐ and long‐term follow‐up of affected children.

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Section: Resultssupporting

confidence: 60%

“…Increased parenchymal echogenicity was reported in 50% of the studies, which is consistent with a diagnosis of 'medical renal disease'. 21,22 Inpatient management Table 5 summarises the inpatient management of APSGN. The majority (61.5%) required at least two anti-hypertensive agents to control their blood pressure.…”

Section: Clinical and Laboratory Featuresmentioning

confidence: 99%

Clinical characteristics of hospitalised children with acute post‐streptococcal glomerulonephritis in the Top End of Australia

Chong

Hung

Hohls

et al. 2023

J Paediatrics Child Health

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“…En el ultrasonido renal se pueden apreciar los riñones aumentados de tamaño (7), los cambios ultrasonográficos se relacionan a la severidad de la presentación, la atrofia tubular e inflamación intersticial son los mecanismos responsables del aumento de ecogenicidad, posibles causantes del proceso atrófico son el engrosamiento de la membrana basal tubular renal y dilatación luminal de los túbulos remanentes. El aumento de ecogenicidad se asocia a una duración mayor de la presentación de hematuria, niveles disminuidos de C3, y a cambios histológicos más severos (18).…”

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Glomerulonefritis aguda post-infecciosa: Evaluación y manejo.

Chaves

Romero

Vargas

2022

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La glomerulonefritis aguda postinfecciosa (GNAPI) es un síndrome mediado inmunológicamente, donde ocurre una lesión glomerular en respuesta a una infección extra renal, la cual en el 95% de los casos es secundaria a una infección faríngea o cutánea, causada por el Estreptococo Beta hemolítico del grupo A. Su prevalencia es mayor en países en vías de desarrollo y se presenta generalmente en población pediátrica entre los 5 y 12 años. Su manifestación clínica es variable, históricamente las principales manifestaciones de la enfermedad son hematuria, edema e hipertensión arterial, síntomas que en conjunto son conocidos como la “triada clínica” nefrítica. En cuanto a la patogenia de GNAPI, ésta es multifactorial; siendo la formación de inmunocomplejos in situ en el espacio subepitelial glomerular ocasionado una reacción de hipersensibilidad tipo III, el mecanismo de mayor relevancia. El diagnóstico es esencialmente clínico, con la corroboración de enfermedad ligada a Estreptococo, mediante distintas pruebas como niveles Anti-DNAasa-B, ASO y C3. El tratamiento la GNAPI se basa en el medidas de soporte, ya que por lo general es un cuadro auto limitado. La restricción hidrosalina y la utilización de fármacos como diuréticos son el tratamiento base en nuestro medio; en algunos casos la utilización de antihipertensivos es necesaria. Es una patología con excelente pronóstico, recurrencia infrecuente y muy baja tasa de complicaciones . En caso de persistencia de afecciones posterior al tiempo estipulado, es pertinente referir a tercer nivel para recibir atención especializada de nefrólogo pediátrico.

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The Relevance between Renal Ultrasonographic Findings and Disease Course in Two Poststreptococcal Glomerulonephritis (PSGN) Patients

Cited by 2 publications

References 6 publications

Clinical characteristics of hospitalised children with acute post‐streptococcal glomerulonephritis in the Top End of Australia

Clinical characteristics of hospitalised children with acute post‐streptococcal glomerulonephritis in the Top End of Australia

Glomerulonefritis aguda post-infecciosa: Evaluación y manejo.

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