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Forum Name: Glomerulonephritis
Question: My 10 Yr Old Girl w/Strep
|MomOf4 - Sat Mar 05, 2005 9:58 pm|
Hello my name is Amy and I have a few concerns about my 10 yr old girl. My ex got custody of her in Oct. and she has gained 20lbs in less than a year and today she has strep throat, and she has been hospitalized for guenonephritis(kidney problem?) in the past and she always has real rosy cheeks all the time. She lives 4 hrs away from me now and I am wondering why she has gained so much weight in such a short period of time.....She gained all of this weight while visiting last summer and going to live in Ohio in October with dad. So she has gained all of this weight in about 7 months. What should I be concerned about with all of the information I have given? Today her father said she is on antibiotics and I understand that.....for the strep..AND also he said she was taking steroids...WHAT DOES THAT MEAN? I have told my ex to keep an eye on her urine samples because she has had protein in her urine in the past and I do know that it is connected to her kidney problems she has had and that strep can bring about kidney problems. What can you tell me about the weight gain and the rosy cheeks and the steroids? Any advice is welcomed.......I would love your input! Thanks everyone!
|Theresa Jones, RN - Sun Mar 06, 2005 4:59 am|
I can understand your concern about the strep. The use of steroids is usually to reduce inflammation etc. However, has the reason for the glomerulonephritis been investigated? That's my concern. Has there been any kidney function studies etc. done?
|MomOf4 - Sun Mar 06, 2005 5:43 pm|
Hello.........Thank you for responding! Well...I have had custody of my girls(Cassidy and Christina) their whole life until Oct 31st when my ex won custody of them...ANYWAYS..In the summer of 2003 Cassidy my 10 yr old was peeing like red brown so I took her to the ER and they admitted her saying her kidneys werent working right--something about the little tubes that go(well you know)ANYWAYS...She stayed for one day and they said she had hat long G word--(the topic above--LOL) so then her Dr. just kept track of her urine and she seemed ok....a couple weeks before that ER visit I remembered she was sick...and they said it was strepto---something something nephritis...Then this past Oct 2005 she got strep and I told the ER to check her urine because of what happened in 2003 summer and she had protein in her urine....So this was just before my ex husband got them and moved to Ohio and I am worried that the Dr in Ohio doesnt know everything about her--and I have told my ex what to watch for in Cassidy......SO NOW she has strep again(and her sister Christina too) and all I can think of is that her kidney "mishap" is going to happen again. I am in PA and she had a great Dr. who knew her whole history and now she has this Dr. with her dad and I hope they got ALL of her medical records. So right now that was it.....no other testing.....I am just worried because I have cared for her for her whole life and know I cant. THANK YOU SO MUCH FOR BEING CONCERNED :lol:
|bruin75 - Sat Sep 10, 2005 8:56 pm|
Sore throat is one of the most common complaint of older children and adults seeking medical attention. While Group A Streptococcus or Streptococcus pyogenes is an important cause of sore throat, viruses are by far more common. The fact that your daughter is on antibiotics in no way assures that she has a strep throat. Unfortunately physicians will prescribe antibiotics emperically without adequately reviewing the criteria that make streptococcal pharyngitis more likely than viral or other pharyngitidies. Sore thrat with inflammed enlarged tonsils and a purulent exudate (pus) and fever suggests a 80-90 percent chance that the presenting symtoms and signs are that of strep throat . Sore throat alone, with tender swollen tonsils suggest a less than a 30 percent chance of having a strep pahryngitis. I have to assume that the physician who started her on antibiotics appropriately screened for evidence of Group A Strep. Given the likelihood that she has Strep pharyngitis, then she is at a small but siginificant risk of developing complications from her infection. These complications were common prior to the development of antiobiotics, but have declined in their prevalence. However they continue to be problematic even in developed countries. These problems are Acute Rheumatic Fever, which I am certain she did not have or else you would have mentioned her symptoms. Toxic Shock Syndrome, which she did not have, and third, Acute Post Streptococcal Glomerulonephritis, the occurrence of which is markedly ameliorated by antibiotic treatment . Poststreptococcal Glomerulonephritis is typically an acute disease, with spontaneous recovery occurring in almost all patients, even those who develop renal insufficiency during the acute episode. Irreversible renal failure probably occurs in less than 1 percent of children and perhaps a slightly higher percentage of adults. It occurs in roughly 5-10 percent of patients with Strep pharyngitis and 25 percent of patients with Strep skin infections. The clinical presentation can vary from asymptomatic, microscopic hematuria (small amounts of blood in the urine undetectable to the eye), to the full-blown acute nephritic syndrome, characterized by red to brown urine, proteinuria (protein in the urine-which can reach the nephrotic range or greater than 3 grams per day, normal being less than 150 milligrams per day), lower extremity or total body swelling, hypertension(high blood pressure) , and acute renal failure. The prognosis is generally favorable.
The fact that she has been hospitalized precviously for glomerulonephritis suggests she has another form of glomerulonephritis. One of the most common glomerulonephritides in children is what is called "Nil disease" or also known as Minimal Change Glomerulonephritis. It is so named because the kidney biopsy appears normal under the light microscope but we see changes under the electron microscope and with immunologic fluorescence testing. That may be why she is on chronic steroids.
Her weight gain, may well be related to steroids, or in fact may be due to diet and growth in combination with steroid use. The rosy cheeks may also have its etiology in the use of steroids but may also suggest she's a healthy, robust 10 year old child.
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