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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
PubMed

Insights

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.
Abstract

Keywords:
Acute post-streptococcal glomerulonephritischronic kidney diseasecomplement activationglomerular inflammationimmune-complexnephritic syndromestreptococcal antigens

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