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- René G. VanDeVoorde III, MD*
- *Division of Pediatric Nephrology and Hypertension, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH.
AUTHOR DISCLOSURE
Dr VanDeVoorde has disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
- ASO:
- antistreptolysin O
- BP:
- blood pressure
- GAS:
- group A Streptococcus
- PSGN:
- poststreptococcal glomerulonephritis
Educational Gaps
If a patient is symptomatic with infectious symptoms and glomerulonephritis simultaneously, other infectious causes besides streptococcus or other causes of nephritis, such as IgA nephropathy, should be considered.
A single antistreptolysin O titer value is not as specific for poststreptococcal glomerulonephritis as a depressed C3 level, although an increase in serial antistreptolysin O titers is more so.
Objectives
After completing this article, readers should be able to:
Recognize the complications of poststreptococcal glomerulonephritis.
Order an appropriate laboratory evaluation of poststreptococcal glomerulonephritis.
Differentiate poststreptococcal glomerulonephritis from other forms of glomerulonephritis.
Know the time sequence of resolution of hypocomplementemia and urinary findings in poststreptococcal glomerulonephritis.
Plan the initial management of poststreptococcal glomerulonephritis.
Understand that poststreptococcal glomerulonephritis rarely progresses to chronic kidney disease.
Case Study
A 5-year-old boy with a history of autism spectrum disorder was seen in his pediatrician’s office approximately 3 weeks ago for a honey-crusted rash on his face, the dorsal aspect of his hands, and his legs. At that time, he was diagnosed as having impetigo and given a prescription for triple antibiotic cream to place on the skin lesions for the next 2 weeks. The lesions improved, but several weeks after the impetigo was diagnosed, the boy became less active and developed swelling of his eyelids, face, and hands. His condition culminated with notably decreased oral intake for a few days and the appearance of coffee-colored urine noted in the toilet, prompting the family to bring the boy to the local emergency department.
On examination, the child is not toxic appearing and does not engage the physician but will interact with his parents. He is afebrile, with a heart rate of 92 beats …
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