Acute Glomerulonephritis
Acute hemorrhagic nephritis is the other name for acute glomerulonephritis. This is the most common form of glomerulonephritis in children. This is a benign form of renal parenchymal disease amd is the result of a hypersensitivity reaction initiated by an infectious agent usually the group A beta hemolytic streptococcus.
The age incidence is between 5 and 11 years with a peak at the age of 8 years. The male to female ratio is 2:3. The incidence is highest during summer months. Poor socioeconomic background increases the prevalence of streptococcal disease and the prevalence of cross infection among household members.
Clinically, the child may present with malaise, fatigue, weakness, anorexia and lethargy. However, the two most common presenting complaints are periorbital edema or gross hematuria ( bloody urine). The edema around the eyes is most noticeable on awakening in the morning but later spreads to the lower extremities and the abdominal wall. Sometimes, headache and shortness of breath are present. In severe cases, patients may have convulsions and scanty to no urine at all.
There is no specific laboratory test that is diagnostic of acute nephritis. However, urinalysis, serum sodium, potassium, chloride, albumin, BUN and cbc are taken to help in the management of the case. The ASO titer is taken to confirm the presence of a previous streptococcal infection. C3 determination is an invaluable tool in the diagnosis of acute gloemrulonephritis.
There is no specific laboratory test that is diagnostic of acute nephritis. However, urinalysis, serum sodium, potassium, chloride, albumin, BUN and cbc are taken to help in the management of the case. The ASO titer is taken to confirm the presence of a previous streptococcal infection. C3 determination is an invaluable tool in the diagnosis of acute gloemrulonephritis.
The most usefeul criteria for diagnosis are as follows:
1. sudden onset of bloody urine (hematuria)
2. a history of infection which could be streptococcal within the immediate past 4 weeks
3. edema
4. hypertension
5. decreased serum C3
6. spontaneous improvement in 4-6 weeks.
The prognosis of acute poststreptococcal nephritis is good. The overall management of acute nephritis is symptomatic and supportive. So long as the acute edematous phase is properly managed spontaneous recovery is the rule.