A 10 years boy presented with Cola coloured urine, oliguria for 3 days, facial puffiness, edema and hypeension. Urine albumin is positive and C3 levels are reduced. BP is 130/80. He had skin infection two weeks back. Which of the following is true about this condition?
The given clinical picture suggests a diagnosis of nephritic syndrome, most probably post-streptococcal glomerulonephritis (PSGN). Poststreptococcal glomerulonephritis (PSGN) is a classic example of the acute nephritic syndrome characterized by the sudden onset of gross hematuria, edema, hypeension, and renal insufficiency. PSGN follows infection of the throat or skin by ceain "nephritogenic" strains of group A b-hemolytic streptococci.( Throat serotypes - M1, M4, M25, and some strains of M12 and skin serotype - M49) Poststreptococcal GN usually affects school-age children (5-12 years of age) and is uncommon below 3 years of age. Lab Diagnosis of PSGN: Antistreptolysin O titer is commonly elevated after a pharyngeal infection but rarely increases after streptococcal skin infections. Best single antibody to document cutaneous streptococcal infection is anti deoxyribonuclease (DNase) B level The serum C3 level is significantly reduced in >90% of patients, and returns to normal 6-8 wk after onset. C4 is most often normal. Serum CH50 is commonly depressed A biopsy is rarely indicated when: renal function is severely impaired beyond 7-10 days serum C3 remains depressed beyond 12 weeks Patient with features of a systemic illness Management of PSGN involves: Symptomatic & suppoive therapy (treating the acute effects of renal insufficiency and hypeension)
Renal biopsy is required in all cases
C3 levels return to normal in 6-8 weeks
Cyclosporine is the treatment of choice
Most common age group involved is 1-4 years
Nephritic & Nephrotic Syndrome