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Post-streptococcal
glomerulonephritis
Post streptococcal glomerulonephritis (PSGN) is an uncommon complication of
either a strep throat or a streptococcal skin infection. PSGN involves
inflammation of the kidney.
Clinical picture
Incidence 5% of those infected with streptococcal sore throat and 50 % of those infected with pyoderma.
Age incidence peaks at 3-12 years with an equal male for female ratio.
Symptoms of PSGN develop within 10 days following a strep throat or 3 weeks
following a GAS skin infection. Symptoms include pale skin, lethargy, loss of
appetite, headache and dull back pain. Clinical findings may include
dark-colored urine, swelling of different parts of the body (edema), and high
blood pressure.
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Diagnosis
Diagnosed by
history, serology and hypocomplementinemia. A biopsy is only needed when the disease
follows an atypical course.
Biopsy: The biopsy shows diffuse proliferative (mesangial and endothelial) exudative (neutrophils and monocytes)
pathology with coarsely granular loop deposits of IgG and C3 and electron dense subepithelial
hump like deposits detected by electron
microscopy.
Treatment
No specific therapy. Treatment of PSGN consists of
supportive care. Some give antibiotics
when cultures prove the presence of streptococcus. Salt and water
retention are treated with diuretics and antihypertensives and salt restriction.
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