Post-streptococcal glomerular nephritis: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
Most common: | Most common: | ||
*edema | |||
*gross hematuria | |||
*hypertension | |||
Varies from asymptomatic to microscopic hematuria to acute nephritic syndrome (gross hematuria, proteinuria, edema, hypertension, and acute kidney injury) | Varies from asymptomatic to microscopic hematuria to acute nephritic syndrome (gross hematuria, proteinuria, edema, hypertension, and acute kidney injury) | ||
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==Work-Up== | ==Work-Up== | ||
*CBC | |||
*Chem 7 | |||
*UA (dysmorphic red blood cells, varying degrees of proteinuria, red blood cell casts, and pyuria) | |||
*Strep antigen serology | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Treatment== | ==Treatment== | ||
*Supportive management (treat volume overload) | |||
** sodium and water restriction | |||
** lasix (also controls HTN) | |||
** consider dialysis (for acute renal failure) | |||
==Disposition== | ==Disposition== | ||
*most have complete recovery, particularly children | |||
*resolution begins within the first two weeks | |||
*small subset have late renal complications (ie, hypertension, increasing proteinuria, and renal insufficiency) | |||
==See Also== | ==See Also== | ||
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==Source== | ==Source== | ||
[[Category:Nephro]] | [[Category:Nephro]] | ||
[[Category:ID]] | [[Category:ID]] | ||
Revision as of 22:32, 25 March 2015
Background
- Abbreviation: PSGN
- most common cause of acute nephritis worldwide
- risk greatest in children 5-12 years old and adults >60
- caused by glomerular immune complex disease induced by specific nephritogenic strains of group A beta-hemolytic streptococcus (GAS)
Diagnosis
Most common:
- edema
- gross hematuria
- hypertension
Varies from asymptomatic to microscopic hematuria to acute nephritic syndrome (gross hematuria, proteinuria, edema, hypertension, and acute kidney injury)
Typically diagnosed by acute nephritis + recent GAS infection
Work-Up
- CBC
- Chem 7
- UA (dysmorphic red blood cells, varying degrees of proteinuria, red blood cell casts, and pyuria)
- Strep antigen serology
Differential Diagnosis
Causes of Glomerulonephritis
- Poststreptococcal glomerulonephritis
- Hemolytic-uremic syndrome
- Henoch-Schonlein purpura
- IgA nephropathy
- Lupus nephritis
- Alport syndrome
- Goodpasture syndrome
- Paraneoplastic
Treatment
- Supportive management (treat volume overload)
- sodium and water restriction
- lasix (also controls HTN)
- consider dialysis (for acute renal failure)
Disposition
- most have complete recovery, particularly children
- resolution begins within the first two weeks
- small subset have late renal complications (ie, hypertension, increasing proteinuria, and renal insufficiency)