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Acute post-streptococcal glomerulonephritis
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Acute post-streptococcal glomerulonephritis

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Contributors: Shea A. Nagle BA, Christine Osborne MD, Catherine Moore MD, Michael W. Winter MD
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Synopsis

Post-streptococcal glomerulonephritis (PSGN) is the most common cause of nephritic syndrome in children. PSGN typically occurs 1-3 weeks after a group A beta hemolytic streptococcal (GAS) pharyngitis or 3-6 weeks after a GAS skin infection. It is thought to be a glomerular immune complex disease leading to complement activation and triggered by specific nephrogenic strains of GAS.

The clinical features of PSGN are varied, with a majority of children presenting with asymptomatic microscopic hematuria. Common clinical features in symptomatic children include peripheral edema, hypertension, gross hematuria with characteristic tea- or cola-colored urine, acute kidney injury, and proteinuria, which at times reaches nephrotic levels.

Children typically have a good prognosis with normalization of creatinine. Adults may have residual effects of hypertension, recurrent proteinuria, and persistence of abnormal renal function.

Codes

ICD10CM:
N00.9 – Acute nephritic syndrome with unspecified morphologic changes

SNOMEDCT:
68544003 – Acute post-streptococcal glomerulonephritis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Clinical history is crucial to the diagnosis of PSGN. A recent history of a GAS infection in the setting of nephritic syndrome symptoms supports the PSGN diagnosis.

Alternative diagnoses to consider:

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed: 01/08/2019
Last Updated: 03/01/2019
Copyright © 2019 VisualDx®. All rights reserved.
Acute post-streptococcal glomerulonephritis
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Acute post-streptococcal glomerulonephritis : Dark urine, Fatigue, Edema, Hematuria, Oliguria, BP increased
Copyright © 2019 VisualDx®. All rights reserved.