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Updated: Oct 18, 2025
Methods for Quantitative Detection of Antibody-induced Complement Activation on Red Blood Cells
Published on: January 29, 2014
Hypocomplementemia (C3) as an independent predictor for children with acute post-streptococcal glomerulonephritis: a
1Department of Pediatrics, Jeju National University School of Medicine, Jeju, Republic of Korea. shinji@yuhs.ac.
Insights
Acute post-streptococcal glomerulonephritis (APSGN) has shown milder clinical patterns and reduced severity in children over 30 years. Monitoring C3 complement levels aids in assessing disease severity and predicting complications like edema and oliguria.
Area of Science:
- Pediatrics
- Nephrology
- Infectious Diseases
Background:
- Acute post-streptococcal glomerulonephritis (APSGN) is a common post-infectious kidney disease in children.
- Understanding temporal trends in APSGN clinical characteristics and severity is crucial for effective management.
Purpose of the Study:
- To investigate changes in the clinical presentation and severity of APSGN in children over a 30-year period.
- To identify factors influencing disease severity and complications.
Main Methods:
- Retrospective analysis of medical records from 119 children diagnosed with APSGN between 1987 and 2018.
- Comparison of clinical, radiological, and laboratory findings between two groups: before 1998 (Group I) and after 1998 (Group II).
Main Results:
- Significant decrease in the frequency of vomiting, oliguria, and generalized edema since 1998.
- Reduced incidence of pulmonary edema on chest X-ray and lower blood urea nitrogen (BUN) levels in the later period.
- C3 complement level identified as a predictor of edema and acute nephritic symptoms, showing a negative correlation with symptom severity.
Conclusions:
- APSGN exhibits more favorable clinical manifestations and reduced severity in contemporary pediatric populations.
- C3 complement levels serve as a valuable biomarker for assessing APSGN severity and predicting complications like edema and oliguria.
- These findings highlight a positive trend in APSGN outcomes among South Korean children over three decades.
Objective:
The aim of this study was to examine the altering patterns in clinical characteristics and severity of acute post-streptococcal glomerulonephritis (APSGN) in children.
Patients And Methods:
We analyzed the medical records of 119 children who were diagnosed with APSGN from 1987 to 2018, retrospectively. The patients were divided into two groups: Group I (n=72, before 1998) and Group II (n=47, after 1998). Clinical, radiologic, and laboratory findings were compared between the two groups.
Results:
The clinical manifestations, including vomiting (20.8% vs. 4.3%, p=0.014), oliguria (40.3% vs. 19.1%, p=0.016), and generalized edema (86.1% vs. 63.8%, p=0.005), were statistically less frequent since 1998. Pulmonary edema on chest X-ray (22.7% vs. 4.4%, p=0.014) was less frequent in Group II than in Group I. The level of BUN (23.3±19.3 vs. 18.8±11.2, p=0.009) was lower in Group II than in Group I, while that of creatinine was not significantly different between the two groups. C3 level was an independent factor for predicting the development of edema (odds ratio [OR]: 1.034, 95% CI: 1.010-1.060, p=0.006) and acute nephritic symptoms (≥2) (OR: 0.974, 95% CI: 0.952-0996, p=0.020). It was also negatively correlated with an increasing number of acute nephritic symptoms, including oliguria and edema, in patients with APSGN (R=-0.182, p=0.048).
Conclusions:
This study demonstrated that APSGN had favorable clinical manifestations and severity over the past 30 years. The monitoring of C3 levels can be used to assess the disease severity and risk of complications, including edema and oliguria, which are decreasing in South Korean children.
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