Bajracharya Prayes, Khadgi Ashish, Shrestha Sugandha, Silwal Ramji, Tandukar Anisha
Department of Pediatrics, Buddha International Hospital, Ghorahi, NPL.
Department of Ear, Nose, and Throat and Head and Neck Surgery, Lamahi Eye Hospital, Lamahi, NPL.
Cureus. 2024 Mar 13;16(3):e56082. doi: 10.7759/cureus.56082. eCollection 2024 Mar.
Post-streptococcal glomerulonephritis is a kidney disease that occurs after infection with a certain strain of streptococcal bacteria. It has a high hospitalization rate, especially in developing countries. It is characterized by the sudden appearance of edema, hematuria, proteinuria, and hypertension. The objective of this retrospective descriptive study conducted at James L. Gordon Memorial Hospital in Olongapo, Zambales, Philippines, is to analyze the demographic distribution, clinical presentation, complication, and outcome of acute post-streptococcal glomerulonephritis (APSGN) in a pediatric population. Methods: A retrospective descriptive study was done in patients (below 18 years of age) admitted with the diagnosis of post-streptococcal glomerulonephritis during a five-year period in the pediatric ward of a tertiary hospital in the Philippines. All patients underwent detailed clinical history and examination and were closely monitored during treatment. The course of disease progression was closely monitored and recorded.
Seventy-seven children were treated for APSGN with a mean age of 7.8 years and with standard deviation of 3.85. Edema and gross hematuria were noted in 53 (68.8%) and 24 (31.1%) cases, respectively. Hypertension was present in 54 patients (70.1%). Among those 54 patients, 49 (63.6%) patients developed acute renal injury (based on normal creatinine for age), three cases (3.8%) had pleural effusion, and two patients (2.5%) developed hypertensive encephalopathy. All patients underwent KUB (kidneys, ureters, and bladder) ultrasound, among which 13 (16.88%) had diffuse parenchymal swelling which improved and eventually were discharged. Increased blood urea nitrogen (BUN) was noted in 60-65% of patients. Hypoalbuminemia and lower hemoglobin were also quite common. There was no mortality during treatment and hospital stay.
APSGN remains one of the most common causes of glomerulonephritis in the region. Edema, hypertension, and hematuria were the most common presenting features. Early identification and comprehensive monitoring and management are required to prevent morbidity and mortality. The prognosis is generally good if early treatment is done.
链球菌感染后肾小球肾炎是一种在感染特定菌株的链球菌后发生的肾脏疾病。其住院率很高，尤其是在发展中国家。其特征为突然出现水肿、血尿、蛋白尿和高血压。在菲律宾三描礼士省奥隆阿波市的詹姆斯·L·戈登纪念医院进行的这项回顾性描述性研究的目的，是分析儿科人群中急性链球菌感染后肾小球肾炎（APSGN）的人口统计学分布、临床表现、并发症及转归。方法：对菲律宾一家三级医院儿科病房在五年期间收治的诊断为链球菌感染后肾小球肾炎的患者（18岁以下）进行回顾性描述性研究。所有患者均接受了详细的临床病史询问和检查，并在治疗期间进行密切监测。密切监测并记录疾病进展过程。
77名儿童接受了APSGN治疗，平均年龄为7.8岁，标准差为3.85。分别有53例（68.8%）和24例（31.1%）出现水肿和肉眼血尿。54例患者（70.1%）存在高血压。在这54例患者中，49例（63.6%）发生急性肾损伤（根据年龄校正后的肌酐正常），3例（3.8%）出现胸腔积液，2例（2.5%）发生高血压脑病。所有患者均接受了肾脏、输尿管和膀胱（KUB）超声检查，其中13例（16.88%）有弥漫性实质肿胀，肿胀情况改善，最终出院。60% - 65%的患者血尿素氮（BUN）升高。低白蛋白血症和血红蛋白降低也相当常见。治疗期间及住院期间无死亡病例。
APSGN仍然是该地区肾小球肾炎最常见的病因之一。水肿、高血压和血尿是最常见的表现特征。需要早期识别以及全面的监测和管理以预防发病和死亡。如果早期进行治疗，预后通常良好。
