Tasic Velibor, Polenakovic Momir
Department of Nephrology, Clinic for Children's Diseases, University Clinical Center, Skopje, Republic of Macedonia.
Turk J Pediatr. 2003 Apr-Jun;45(2):148-51.
A four-year old boy was admitted to the hospital due to acute thrombocytopenic purpura. Three days later he developed edema, hematuria and hypertension. The diagnosis of acute poststreptococcal glomerulonephritis was based upon the evidence of previous sore throat, hypocomplementemia and increased antistreptolysin O titer. Renal biopsy was contraindicated due to throbocytopenia. An extensive work-up was done to exclude mebranoproliferative glomerulonephritis and systemic diseases such as hemolytic uremic syndrome or systemic lupus erythematosus. The clinical outcome of the nephritis and thrombocytopenia was excellent in respect to both conditions. To the best of our knowledge concurrent occurrence of acute thrombocytopenic purpura and poststreptococcal glomerulonephritis is very rare; there are only four similar cases reported in the literature. A careful work-up and follow-up are mandatory to exclude systemic disease.
一名4岁男孩因急性血小板减少性紫癜入院。三天后,他出现水肿、血尿和高血压。急性链球菌感染后肾小球肾炎的诊断基于先前咽痛、补体血症降低和抗链球菌溶血素O滴度升高的证据。由于血小板减少,肾活检被视为禁忌。进行了广泛的检查以排除膜增生性肾小球肾炎和溶血性尿毒症综合征或系统性红斑狼疮等全身性疾病。肾炎和血小板减少症的临床结果在两种情况下都非常好。据我们所知,急性血小板减少性紫癜和链球菌感染后肾小球肾炎同时发生的情况非常罕见;文献中仅报道了4例类似病例。必须进行仔细的检查和随访以排除全身性疾病。