Pol. Merkur. Lek (Pol. Med. J.), 2019, XLVI/273: 115-121 Maximize

Pol. Merkur. Lek (Pol. Med. J.), 2019, XLVI/273: 115-121

Title: Increased frequency of acute poststreptococcal glomerulonephritis in the first half of 2018 – single-center experience 

Authors: Leszczyńska A, Skrzypczyk P, Leszczyńska B, Kuźma-Mroczkowska E, Brzewski M, Pańczyk-Tomaszewska M. 

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Increased frequency of acute poststreptococcal glomerulonephritis in the first half of 2018 – single-center experience

Leszczyńska A1, Skrzypczyk P2, Leszczyńska B2, Kuźma-Mroczkowska E2, Brzewski M3, Pańczyk-Tomaszewska M2.

Medical University of Warsaw: 1Student Scientific Group at the Department of Pediatrics and Nephrology; 2Department of Pediatrics and Nephrology; 3Department of Pediatric Radiology

Acute poststreptococcal glomerulonephritis (APSGN) is a complication of infection with group A beta-hemolytic streptococcus. The disease manifests as microscopic/gross hematuria, arterial hypertension, edema, and acute kidney injury and has most commonly self-limiting course.
The aim of study
was the analysis of clinical course of APSGN in period of increased incidence in the first half of 2018.
Material and methods
. We analyzed following parameters in children hospitalized due to APSGN in January-June 2018: age, sex, anthropometric parameters, preceding infection, clinical signs, renal function, biochemical and immunological tests (including antristreptolysins (ASO) and complement), urinalysis, renal ultrasonography, and treatment. The incidence of APSGN in years 2007-2018 was analyzed.
. We found 11 children (6 boys, 5 girls) aged 5.01±2.44 years. The disease was preceded by pharyngitis in 8, skin infection in 1 with latent period 16.40±5.77 days. Clinical symptoms were: gross hematuria in 8, edema in 6, hypertension in 5, renal function impairment 6, and hyperkalemia in 5; all patients had lowered C3 complement factor; ASO was elevated in all patients except for a boy with skin infection. During hospitalization clinical symptoms resolved in all children; significant elevation in GFR (p=0.018) and C3 (p=0.034), and decrease in proteinuria (p=0.039) were observed. Four patients with abnormal ultrasonographic kidney image were characterized by worse kidney function (p=0.018), higher potassium concentration (p=0.052), higher proteinuria (p=0.073) and erythrocyturia (p=0.015) than remaining children. In follow-up (after 142,00±89,20days) all children had normal renal function and blood pressure, 1 patient had proteinuria, and 4 had erythrocyturia.
. In most cases APSGN is characterized by rapid resolution of symptoms and good prognosis, but patients require periodic follow-up visits. Abnormal initial ultrasonographic kidney image may be a marker of worse clinical course of APSGN.

Key words: acute poststreptococcal glomerulonephritis, nephritic syndrome, Streptococcus pyogenes, children

Pol Med J, 2019; XLVI (273); 115–121