Glomerulo-nephritis, acute poststreptococcal
LIFE-THREATENING DISORDERAlso called acute glomerulonephritis, acute poststreptococcal glomerlo-nephritis (APSGN) is a relatively common bilateral inflammation of the
glomeruli. It follows a streptococcal infection of the respiratory tract or, less commonly, a skin infection such as impetigo.
glomeruli. It follows a streptococcal infection of the respiratory tract or, less commonly, a skin infection such as impetigo.
APSGN is most common in males ages 6 to 10 but can occur at any age. Up to 95% of children and up to 70% of adults with APSGN recover fully; the remainder of patients may progress to chronic renal failure within months.
Causes
APSGN results from the entrapment and collection of antigen-antibody complexes (produced as an immunologic mechanism in response to streptococci) in the glomerular capillary membranes, inducing inflammatory damage and impeding glomerular function.
Sometimes the immune complement further damages the glomerular membrane. The damaged and inflamed glomerulus loses the ability to be selectively permeable and allows red blood cells (RBCs) and proteins to filter through as the glomerular filtration rate (GFR) falls. Uremic poisoning may result.
Signs and symptoms
APSGN begins within 1 to 3 weeks after untreated pharyngitis. Symptoms are mild to moderate edema, oliguria (less than 400 ml/24 hours), proteinuria, azotemia, hematuria, and fatigue.
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