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8 岁胸痛伴肌钙蛋白 I 升高女孩的不常见病因。

An unusual etiology in an 8-year-old girl with chest pain and elevated troponin-I.

机构信息

Division of Pediatric Nephrology, Atatürk Sanatoryum Training and Research Hospital, Ankara, Turkey.

Division of Pediatric Cardiology, Atatürk Sanatoryum Training and Research Hospital, Ankara, Turkey.

出版信息

Pediatr Nephrol. 2024 Oct;39(10):2915-2917. doi: 10.1007/s00467-024-06368-8. Epub 2024 Apr 12.

Abstract

Acute post-streptococcal glomerulonephritis (APSGN) is the most common glomerulonephritis of childhood, and clinical presentation can vary widely. This case report presents an atypical manifestation of APSGN in an 8-year-old female patient with pleuritic chest pain and elevated troponin-I, despite lacking classical kidney symptoms. Imaging studies showed cardiomegaly and interstitial lung opacities. Further investigations revealed hematuria and proteinuria, and the diagnosis was confirmed through elevated antistreptolysin-O (ASO) titers and low complement 3 (C3) levels. The patient was successfully managed with fluid restriction, diuretics, and antihypertensives, resulting in the resolution of symptoms and normalization of laboratory values. This case highlights the significance of recognizing atypical manifestations of APSGN for ensuring prompt diagnosis and proper management in the pediatric population.

摘要

急性链球菌后肾小球肾炎(APSGN)是儿童最常见的肾小球肾炎,临床表现差异很大。本病例报告介绍了一例 8 岁女性患者的不典型 APSGN 表现,该患者有胸痛和肌钙蛋白 I 升高,但缺乏典型的肾脏症状。影像学检查显示心脏扩大和间质性肺混浊。进一步的检查显示血尿和蛋白尿,通过升高的抗链球菌溶血素 O(ASO)滴度和低补体 3(C3)水平确诊。该患者通过限制液体摄入、利尿剂和抗高血压药物成功治疗,症状得到缓解,实验室值恢复正常。本病例强调了识别 APSGN 不典型表现的重要性,以便在儿科人群中及时诊断和适当治疗。

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