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链球菌感染后肾小球肾炎的综合综述研究

A Comprehensive Review Study on Glomerulonephritis Associated With Post-streptococcal Infection.

作者信息

Alhamoud Mustafa A, Salloot Ibrahim Z, Mohiuddin Shamim S, AlHarbi Turki M, Batouq Faisal, Alfrayyan Naif Y, Alhashem Ahmad I, Alaskar Mohammad

机构信息

Medicine, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, SAU.

Biochemistry, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, SAU.

出版信息

Cureus. 2021 Dec 6;13(12):e20212. doi: 10.7759/cureus.20212. eCollection 2021 Dec.

Abstract

Post-streptococcal glomerulonephritis (PSGN) is an immune-complex mediated inflammation that used to be considered one of the commonest causes of acute nephritis amongst children. PSGN is characterized by the proliferation of cellular elements called nephritogenic M type as a result of an immunologic mechanism following an infection of the skin (impetigo) or throat (pharyngitis) caused by nephritogenic strains of group A beta-hemolytic streptococci, a gram-positive bacteria that enters the body across pores in the skin or mucus epithelia and is responsible for more than 500,000 deaths annually due to multiple subsequence diseases such as rheumatic heart disease, rheumatic fever, PSGN, and other invasive infections. After the infection, the formation of an immune complex of antigen-antibody and complement system will take place and will deposit in the glomeruli where the injury occurs and leads to inflammation. The manifestations of PSGN can be explained by nephritic syndrome manifestation. PSGN is diagnosed by laboratory tests like microscopy and urinalysis. The imaging studies in PSGN could be used to assess the possible complications of PSGN such as pulmonary congestion and chronic kidney disease. The management of PSGN is symptomatic. If PSGN is not treated, the patient may develop chronic kidney disease. The main way to prevent PSGN is to treat group A streptococcal (GAS) infections by giving good coverage of antibiotic therapy to a patient who has primary GAS infections to prevent the development of the complication.

摘要

链球菌感染后肾小球肾炎(PSGN)是一种免疫复合物介导的炎症,曾被认为是儿童急性肾炎最常见的病因之一。PSGN的特征是,在A组β溶血性链球菌致肾炎菌株(一种革兰氏阳性菌,可通过皮肤毛孔或黏液上皮进入人体,每年因风湿性心脏病、风湿热、PSGN和其他侵袭性感染等多种后续疾病导致超过50万人死亡)感染皮肤(脓疱病)或咽喉(咽炎)后,由于免疫机制,称为致肾炎M型的细胞成分会发生增殖。感染后,抗原 - 抗体和补体系统会形成免疫复合物,并沉积在发生损伤并导致炎症的肾小球中。PSGN的表现可用肾病综合征表现来解释。PSGN通过显微镜检查和尿液分析等实验室检查来诊断。PSGN的影像学研究可用于评估PSGN的可能并发症,如肺充血和慢性肾病。PSGN的治疗以对症治疗为主。如果不治疗PSGN,患者可能会发展为慢性肾病。预防PSGN的主要方法是通过对原发性A组链球菌(GAS)感染患者给予充分的抗生素治疗来治疗GAS感染,以预防并发症的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c620/8730744/bb231eb95a3d/cureus-0013-00000020212-i01.jpg

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