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Sunday, April 12, 2009

Acute Poststreptococcal Glomerulonephritis

12:30 PM


ALSO KNOWN AS
APSGN

DESCRIPTION
* This is the most common form of glomerulonephritis, a disorder marked by inflammation of the kidneys' glomeruli.

SYMPTOMS
* Dark brown urine
* Periorbital swelling
* Shortness of Breath
* Rapid breathing
* Pallor
* High blood pressure
* Diarrhea
* Decreased urine output
* Seizures

CAUSE
* Streptococcal infection (nephritogenic strain)
* Pharyngitis -- M type 12
* Skin Infection: M type 49

HOW THE DIAGNOSIS IS MADE
* Streptococcal infection evidence
* Laboratory tests:

1. Manual blood count shows anemia
2. Elevated blood urea nitrogen (BUN) level
3. Elevated creatinine (Cr) level
4. Streptococcus serologic tests (ASO, antihyaluronidase, antideoxyribonuclease) level
5. Decreased complement 3 level
Microscopic urine examine shows protein, RBC, WBC in urine

TREATMENT
* Penicillin for 10 days
* For kidney failure:

1. Restrict fluid
2. Maintain calories
3. Correction of electrolyte disturbance

* For high blood pressure:

1. Hospitalization
2. Diazoxide for pulmonary edema

COMPLICATIONS
* Acute renal failure
* Hypertensive encephalopathy
* Heart failure

PROGNOSIS
* Ninety-five percent of patients recover completely.

IF YOU SUSPECT THIS CONDITION
* Your child needs to be hospitalized if he/she has high blood pressure.

SIMILAR CONDITIONS
* Lupus nephritis
* Membranoproliferative glomerulonephritis (MPGN)
* Nephritis due to bacterial endocarditis
* Shunt nephritis




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