Acute Poststreptococcal Glomerulonephritis (APSGN) in Children in Sisaket Hospital
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Abstract
Objective: To study the incidence, clinical manifestation, laboratory investigation, result and clinical course of pediatric patients with APSGN in Sisaket Hospital.
Patient and method: All pediatric patients diagnosed with APSGN from 1st January 2001 to 31st December 2004 were retrospectively reviewed about the incidence, clinical manifestation, laboratory investigation, result and clinical course.
Result: There were 64 patients, 40 boys and 24 girls with the age average of 8.1 years old. Most of cases occurred between 6 and 8 years of age. The incidence was high in the rainy (June - August) and cold (December) seasons. APSGN usually is secondary to pharyngitis and pyoderma. Pyoderma was more frequent than pharyngitis. Clinical manifestations were included edema (95.31%), hypertension (82.81%), gross hematuria (46.87%) and oliguria (29.68%). Laboratory investigations were microscopic hematuria (100%), proteinuria (89.06%), average blood urea nitrogen and serum creatinine about 26.13 and 1.18 mg/dL, respectively. Evidence of recent streptococcal infection in this study represent by antistreptolysin o (ASO) titer which was found more than 333 Todd unit about 54.68%. There were 3 patients with complication, 1 hypertensive encephalopathy, 2 rapidly progressive glomerulonephritis. Gross hematuria, hypertension, proteinuria and microscopic hematuria disappeared within 8.73, 9.3, 47.1 1, 143.16 days, respectively and maximum follow - up period were 60, 18, 240, 270 days, respectively. There were 40 recovered patients, 9 patients lost to follow up and 15 patients are still being followed up. Evidence of recurrence was not found.
Conclusion: APSGN still be not uncommon in Sisaket hospital. The incidence of severe hypertension was high about 67.19% but gross hematuria was only 46.87%. Acute renal failure was more common than other studies. Although APSGN has typical clinical manifestations, specific diagnostic investigations should be done. The prognosis of APSGN during hildren is excellent, when adequately diagnosed and treated.
Keyword: Acute poststreptococcal glomerulonephritis.
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References
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