Protracted Clinical Course of Postinfectious Glomerulonephritis in a Previously Healthy Child

Treatment outcome of post-streptococcal acute glomerulonephritis and its associated factors among children less than 15 years at the referral hospital of East Amhara, Ethiopia

OBJECTIVES

Aimed to assess the treatment outcome of post-streptococcal acute glomerulonephritis and its associated factor among children of less than 15 years at a referral hospital in Amhara Northeast Ethiopia, 2022.

RESULTS

In this study, 322 Post- post-streptococcal acute glomerulonephritis children with a response rate of 97% were included. Of these, 33.54% of them had a poor treatment outcome. Age less than or equal to 5 years (AOR = 3.2, 95% CI (1.5-7.3), Creatinine level > 1.3 mg/dl (AOR = 5.5,95% CI (2.5-11.7), blood urea nitrogen leve ≥ 119 mg/dl (AOR = 4.9,95% CI (1.1-19) and length of stay > 10 days(AOR = 2.6,95% CI (1.18-5.9) were statistically significant with poor outcome of children with post-streptococcal acute glomerulonephritis and management during admission to reduce poor treatment outcomes.

Unusual presentation of familial Mediterranean fever with co-existing polyarteritis nodosa and acute post-streptococcal glomerulonephritis

Acute post-streptococcal glomerulonephritis (APSGN) and polyarteritis nodosa (PAN) may occur simultaneously after streptococcal infection in a child who is previously healthy but carries a Mediterranean fever (MEFV) mutation. The homozygous M694V mutation in the MEFV gene may cause an augmented response to the streptococcal infection that plays a role in the development of both clinical manifestations.

Postinfectious Glomerulonephritis

Postinfectious glomerulonephritis continues to be the most common cause of acute glomerulonephritis in children. Although in the past it was considered to be mainly a complication of streptococcal infections, today it is well known that infection with many other pathogens may trigger an immune response that results in glomerular injury. Most children with postinfectious glomerulonephritis have an excellent prognosis with complete recovery of renal function and no recurrence. This article summarizes the history, presentation, evaluation, differential diagnosis, and management of children with postinfectious glomerulonephritis. [Pediatr Ann. 2020;49(6):e273-e277.].

Assessment of the etiologies and renal outcomes of rapidly progressive glomerulonephritis in pediatric patients at King Abdulaziz University Hospital, Jeddah, Saudi Arabia

Objectives:

To investigate the etiologies and outcomes of rapidly progressive glomerulonephritis (RPGN) in pediatric patients at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia.

Methods:

A retrospective study was conducted in 19 pediatric patients who were diagnosed with RPGN between 2006 and 2016 at the Department of Pediatric Medicine at KAUH. Associations between variables were evaluated using independent t-test, one-way analysis of variance (ANOVA) and Chi-squared tests.

Results:

Majority of patients were male, (68.4%), with a mean±SD age at diagnosis of 8.52±3.15 years. The most common underlying etiologies were post-infectious glomerulonephritis (PIGN) (63.2%) and lupus nephritis (21.1%). Thirteen patients exhibited a good clinical prognosis (68.4%), with 6 exhibiting a poor prognosis (31.6%), 4 of whom progressed to end-stage renal disease (ESRD), one experiencing a relapse and one developing chronic kidney disease. Post-infectious glomerulonephritis was associated with the best clinical outcome overall. Treatment was implemented early in most patients and continued for 3 months. Among the 19 patients, 2 died and one underwent hemodialysis.

Conclusion:

Post-infectious glomerulonephritis was the most common etiology of RPGN, with these patients achieving a good clinical prognosis overall. Early identification and treatment of RPGN is important to preserve renal function, which is a key factor for achieving a good prognosis.