II. Epidemiology
- Previously, most common cause of Glomerulonephritis, but has decreased significantly in the U.S.
- As of 2018, most cases occur in underserved regions
- Previously most often in childhood (ages 2 to 6)
- Now more common in age >60 years old, especially with comorbidities
III. Pathophysiology
- Prototype for Acute Glomerulonephritis
- Follows Group A Beta Hemolytic Streptococcus Infection
- Onset 3 to 6 weeks after infection
IV. Symptoms: Nephritic Syndrome
- Presentations vary
- May be as mild as asymptomatic Microscopic Hematuria
- May be as severe as Gross Hematuria with oliguric Acute Renal Failure
- Flank Pain is variably present
- General symptoms
V. Signs
VI. Labs
- Basic chemistry panel
- Acute Renal Failure may be present
- Serum Creatinine increased
- Urinalysis
-
Group A Streptococcal Pharyngitis diagnosis
- GAS Rapid Strep Test with reflex to Throat Culture if negative
- ASO Titer increased on serial measurements
- Other labs
- Serum Complement decreased
VII. Diagnosis: Renal biopsy
- Indications: Diffuse proliferative Glomerulonephritis
- Severe or progressive Renal Failure
- Delayed resolution of clinical illness
- Systemic signs (Joint Pain, fever, Hepatomegaly)
VIII. Management
- Supportive care
-
Edema and Hypertension
- Salt and water restriction
- Furosemide (Lasix)
- Management of edema and Hypertension, if present
-
Acute Renal Failure
- Dialysis is rarely indicated
- Renal Function typically improves in 4-6 weeks after onset
- Urine
- Expect diuresis to occur in the first week of presentation
- Hematuria resolves in first 3-6 months
- Proteinuria typically resolves over first 3 years
IX. Prognosis
- Most cases are self limited (95%)
- Resolve within 4 weeks without residua
- Relapse is rare, but may occur
- Adults do worse then children
- Higher risk of Chronic Glomerulonephritis
X. References
- Rodriguez-Iturbe in Ferretti (2016) Streptococcus Pyogenes, Oklahoma City , University of Oklahoma HSC
- Maness (2018) Am Fam Physician 97(8): 517-22 [PubMed]
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Related Studies
| Concepts | Disease or Syndrome (T047) |
| SnomedCT | 68544003 |
| Italian | Glomerulonefrite post-streptococcica |
| English | Post streptococcal glomerulonephritis, acute poststreptococcal glomerulonephritis (diagnosis), acute poststreptococcal glomerulonephritis, PSGN - Post-streptococcal GN, Post-streptococcal GN, Acute post-streptococcal glomerulonephritis, PSGN - Post-streptococcal glomerulonephritis, Post-streptococcal glomerulonephritis, Acute post-streptococcal glomerulonephritis (disorder), glomerulonephritis; poststreptococcal, acute, glomerulonephritis; poststreptococcal, poststreptococcal; glomerulonephritis, acute, poststreptococcal; glomerulonephritis, Post-Streptococcal Glomerulonephritis, Acute poststreptococcal glomerulonephritis |
| Japanese | レンサ球菌感染後糸球体腎炎, ﾚﾝｻｷｭｳｷﾝｶﾝｾﾝｺﾞｼｷｭｳﾀｲｼﾞﾝｴﾝ |
| Czech | Poststreptokoková glomerulonefritida |
| Hungarian | poststreptococcalis glomerulonephritis |
| Dutch | glomerulonefritis; poststreptokokken, acuut, glomerulonefritis; poststreptokokken, poststreptokokken; glomerulonefritis, acuut, poststreptokokken; glomerulonefritis, poststreptokokken glomerulonefritis |
| Spanish | glomerulonefritis aguda posestreptocócica (trastorno), glomerulonefritis aguda posestreptocócica, Glomerulonefritis postestreptocócica |
| Portuguese | Glomerulonefrite pós-estreptocócica |
| French | Glomérulonéphrite post streptococcique |
| German | Glomerulonephritis nach Streptokokkeninfektion |
