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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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