Fever in Acute Post-Streptococcal Glomerulonephritis: Prevalence and Clinical Significance

Acute post-streptococcal glomerulonephritis (APSGN) is a common cause of glomerulonephritis in children following infection with group A β-hemolytic streptococcus (GAS). Fever has been uncommonly reported in APSGN, and its clinical significance has not been assessed. Fever and elevated inflammation markers might be related to altered kidney outcomes. This study aimed to evaluate the prevalence and significance of fever among pediatric patients with APSGN.

We performed a single-center retrospective analysis of patients diagnosed with APSGN from 2005 to 2024. Inclusion criteria encompassed clinical signs of glomerulonephritis, low serum C3 levels, and evidence of GAS infection. We compared short- and medium-term kidney outcomes, including estimated glomerular filtration rate, blood pressure, hematuria, and proteinuria between febrile and afebrile patients.

Of the 69 eligible patients with APSGN, 24 (34.8%) presented with fever. Febrile patients exhibited symptoms of infection, mostly viral diseases, had higher C-reactive protein levels, and experienced prolonged hospital stay compared to afebrile patients. However, there were no significant differences between the groups in the severity of glomerulonephritis or medium-term kidney outcomes.

Fever is a common presenting symptom in pediatric patients with APSGN. It is associated with prolonged hospital stay and higher serum inflammation markers, but is not significantly associated with a worse short- or medium-term kidney prognosis.

Fever is a frequent presenting symptom in pediatric patients with acute post-streptococcal glomerulonephritis (APSGN). Although it is associated with prolonged hospitalization and increased C-reactive protein levels, it does not alter short or medium-term outcomes.