Description
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Explanation & Answer
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Acute poststreptococcal glomerulonephritis is
one of the most common glomerular causes of
gross hematuria in children
it is a classic example of the acute nephritic
syndrome
characterized by
the sudden onset of gross hematuria
edema
hypertension
renal insufficiency
oliguria
ETIOLOGY AND EPIDEMIOLOGY.
Acute poststreptococcal glomerulonephritis
follows infection of the throat or skin by certain
“nephritogenic” strains of group A β-hemolytic
streptococci.
throat (serotype 12)
skin (serotype 49) infections
The factors that allow only certain strains of
streptococci to be nephritogenic remain unclear
Poststreptococcal glomerulonephritis
commonly
follows
streptococcal pharyngitis during cold weather
months
streptococcal skin infections or pyoderma
during warm weather months.
this disease occurs commonly sporadic.
epidemics of nephritis have been described
in association with both throat (serotype 12)
and skin (serotype 49) infections
PATHOGENESIS.
morphologic studies and a depression in the
serum complement (C3) level strongly suggest
that poststreptococcal glomerulonephritis is
mediated by immune complexes
the precise mechanisms by which nephritogenic
streptococci induce complex formation remain to
be determined.
complement activation is primarily through
the alternative (immune complex–
activated) pathway.
Antigen-antibody complexes form after
infection and are deposited in glomeruli
causing inflammation and complement
consumption
It is most common in children aged 5–
12 yr
o uncommon before the age of 3 yr.
o
The typical patient develops an acute nephritic
syndrome
1–2 wk after streptococcal pharyngitis
3–6 wk after a streptococcal pyoderma.
The severity of renal involvement varies from
asymptomatic microscopic hematuria with
normal renal fun...