Post-streptococcal glomerular nephritis: Difference between revisions
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==Background== | ==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== | ==Diagnosis== | ||
Revision as of 22:05, 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
DDx
Insert
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)
See Also
Source
KajiQuestions