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Acute Post-Streptococcal Glomerulonephritis in Children: A Comprehensive Review
Sérgio Veloso Brant Pinheiro1, Victor Buchini de Freitas2, Gustavo Valverde de Castro2
1Department of Pediatrics, Unit of Pediatric Nephrology, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
Current Medicinal Chemistry
|June 15, 2022
Summary
Acute post-streptococcal glomerulonephritis (APSGN) is a kidney injury in children caused by Streptococcus infections. While often resolving spontaneously, understanding its pathogenesis and preventing complications is key to reducing morbidity.
Area of Science:
- Nephrology
- Pediatric Nephrology
- Immunology
Background:
- Acute post-streptococcal glomerulonephritis (APSGN) is an immune-complex mediated glomerular disease.
- It is triggered by Group A Streptococcus (GAS) infections and is a significant cause of acquired kidney injury in children.
Purpose of the Study:
- To review recent evidence on APSGN, covering epidemiology, pathogenesis, clinical and laboratory findings, histopathology, treatment, and prognosis.
- To provide an overview of this common childhood kidney disease.
Main Methods:
- Non-systematic review of current literature on APSGN.
- Discussion of epidemiological data, pathogenic mechanisms, clinical presentation, diagnostic findings, and therapeutic approaches.
Main Results:
- APSGN incidence is higher in developing countries (24.3/100,000) than developed countries (6.2/100,000).
- Key streptococcal antigens (e.g., nephritis-associated plasmin receptor, streptococcal pyrogenic exotoxin B) activate the complement system, leading to IC deposition and glomerulonephritis.
- Classic presentation includes nephritic syndrome (hematuria, oliguria, hypertension, edema) with characteristic histopathological findings of diffuse proliferative glomerulonephritis.
Conclusions:
- The pathogenesis of APSGN requires further elucidation.
- No specific treatment exists, but management focuses on preventing and treating complications, leading to generally good prognosis with rare progression to chronic kidney disease.
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