Post-streptococcal glomerular nephritis: Difference between revisions
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==Background== | ==Background== | ||
*Abbreviation: PSGN | *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) | ||
== | ==Clinical Features== | ||
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) | ||
| Line 15: | Line 15: | ||
Typically diagnosed by acute nephritis + recent GAS infection | Typically diagnosed by acute nephritis + recent GAS infection | ||
==Work-Up== | ==Differential Diagnosis== | ||
{{Glomerulonephritis causes}} | |||
==Diagnosis== | |||
===Work-Up=== | |||
*CBC | *CBC | ||
*Chem 7 | *Chem 7 | ||
| Line 22: | Line 26: | ||
*UA (dysmorphic red blood cells, varying degrees of proteinuria, red blood cell casts, and pyuria) | *UA (dysmorphic red blood cells, varying degrees of proteinuria, red blood cell casts, and pyuria) | ||
== | ==Management== | ||
*Supportive management (treat volume overload) | *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== | ||
[[Strep_Pharyngitis|Strep Pharyngitis]] | [[Strep_Pharyngitis|Strep Pharyngitis]] | ||
== | ==References== | ||
<references/> | |||
[[Category:Nephro]] | [[Category:Nephro]] | ||
[[Category:ID]] | [[Category:ID]] | ||
Revision as of 04:05, 18 August 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)
Clinical Features
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
Differential Diagnosis
Causes of Glomerulonephritis
- Poststreptococcal glomerulonephritis
- Hemolytic-uremic syndrome
- Henoch-Schonlein purpura
- IgA nephropathy
- Lupus nephritis
- Alport syndrome
- Goodpasture syndrome
- Paraneoplastic
Diagnosis
Work-Up
- CBC
- Chem 7
- Streptozyme assay including ASO
- Complement C3, C4, C50
- UA (dysmorphic red blood cells, varying degrees of proteinuria, red blood cell casts, and pyuria)
Management
- 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)