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[Effect of various infections on the development, course and outcome of glomerulonephritis in children]
Insights
Infections, including bacterial, viral, and mixed types, alongside HBs-antigenemia, negatively impact acute glomerulonephritis in children. Persistent viral antibodies also adversely affect disease outcomes.
Area of Science:
- Pediatrics
- Infectious Diseases
- Nephrology
Background:
- Acute glomerulonephritis (AGN) is a significant renal disease in children.
- Identifying infectious triggers and co-infections is crucial for understanding AGN pathogenesis and prognosis.
- The role of specific viral and bacterial agents, as well as hepatitis B virus (HBV) infection, in AGN requires further elucidation.
Purpose of the Study:
- To investigate the prevalence of bacterial and viral infections in children with AGN.
- To assess the impact of identified infections and HBs-antigenemia on the clinical course and outcomes of AGN.
- To examine the long-term effects of viral antibodies on AGN prognosis.
Main Methods:
- Bacteriological and virological testing of throat mucus and blood serum from 100 children with AGN.
- Detection of bacterial pathogens (Streptococci, Staphylococci) and viral antigens (Influenza A1, A3, B; Parainfluenza 1, 3; Adenovirus; RSV) using direct immunofluorescence.
- Analysis of HBs-antigens and specific viral/bacterial antibodies in serum.
- Correlation of infection status and HBs-antigenemia with AGN course and outcome.
Main Results:
- Bacterial infections were present in 52.5%, viral in 12.5%, and mixed infections in 27.5% of patients at AGN onset.
- HBs-antigenemia was detected in 25.5% of the children.
- Both HBs-antigenemia and mixed infections were associated with adverse effects on AGN course and outcomes.
- Long-term circulation of viral antibodies, particularly to Parainfluenza-3, was linked to poorer AGN outcomes.
Conclusions:
- Bacterial and viral co-infections, along with HBs-antigenemia, are common in pediatric AGN and worsen prognosis.
- Hepatitis B virus infection and mixed infections represent significant risk factors for adverse outcomes in acute glomerulonephritis.
- Persistent viral antibody responses may indicate a more severe disease course and poorer long-term outcomes in children with AGN.
Abstract:
Bacteriological and virological tests were made at the disease onset and repeatedly in 100 children (66 boys and 34 girls) aged 2 to 15 years suffering from acute glomerulonephritis. The throat mucus was found to contain streptococci and staphylococci; direct immunofluorescence demonstrated antigens of influenza A1, A3, B virus, of parainfluenza virus, serotypes 1 and 3, of adenovirus and respiratory and syncytial virus; HBs-antigens, specific viral and bacterial antibodies were detected in the blood serum. At the onset of acute glomerulonephritis, 52.5% of the patients were diagnosed to have bacterial infection, 12.5% respiratory viral infection, and 27.5% mixed infection (respiratory viral and bacterial). Besides, 25.5% of the patients showed HBs-antigenemia. HBs-antigenemia and mixed (respiratory viral and bacterial) infection were found to produce an adverse effect on the course and outcome of acute glomerulonephritis. Long-term circulation of some viral antibodies (mostly to parainfluenza-3 antigen) was revealed on repeated studies as was their untoward effect on the outcome of acute glomerulonephritis.