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Pneumonia-associated acute glomerulonephritis

T Srivastava1, Warady, U S Alon

  • 1Section of Nephrology, The Children's Mercy Hospital, University of Missouri at Kansas City 61408, USA.

Clinical Nephrology
|April 2, 2002
PubMed

Insights

Pneumonia in children can sometimes coincide with acute glomerulonephritis (AGN), a kidney inflammation. Most cases of pneumonia-associated AGN resolve well, but some children may need medical intervention for kidney issues.

Area of Science:

  • Pediatric Nephrology
  • Pediatric Pulmonology
  • Infectious Diseases

Background:

  • Post-infectious glomerulonephritis (PIGN) typically manifests 7-14 days post-infection.
  • Acute glomerulonephritis (AGN) has been observed to occur concurrently with pneumonia in some pediatric cases.
  • The clinical course and outcomes of pneumonia-associated AGN require further delineation.

Purpose of the Study:

  • To investigate the clinical presentation and prognosis of children experiencing acute glomerulonephritis (AGN) concurrently with pneumonia.
  • To identify key indicators for evaluating children with pneumonia for concomitant glomerulonephritis.

Main Methods:

  • Retrospective review of hospital records from 1984-1999.
  • Inclusion criteria: children admitted with both acute pneumonia and AGN diagnosed within 72 hours of each other.
  • Analysis of clinical data, laboratory results, urinalysis, and treatment outcomes.

Main Results:

  • Eleven boys (age 3.8-12.7 years) with pneumonia-associated AGN were identified.
  • All patients received antibiotics for pneumonia; most showed resolution of respiratory symptoms.
  • Abnormal urinalysis (hematuria, proteinuria, casts), elevated creatinine, low complement C3, and elevated ASO titers were common.
  • Hypertension and azotemia were observed in several children; most normalized with follow-up.
  • One child required dialysis for severe oliguria; kidney biopsy revealed acute proliferative glomerulonephritis.

Conclusions:

  • Children with pneumonia presenting with abnormal urinalysis, hypertension, azotemia, or oliguria should be assessed for concurrent glomerulonephritis.
  • Pneumonia-associated AGN generally follows a benign course with a favorable prognosis in most pediatric cases.
  • Short-term medical interventions may be necessary for some children with pneumonia-associated AGN.
Abstract

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