• Childhood Kidney Diseases
• /
• v.19 no.1
• /
• pp.43-47
• /
• 2015

Hemolytic anemia and thrombocytopenia are rare clinical manifestations of acute glomerulonephritis. Initially, in all such cases, a diagnosis of hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, systemic lupus erythematosus, and amyloidosis should be ruled out. The presence of hemolytic anemia and thrombocytopenia is rare, but possible, in a case of acute poststreptococcal glomerulonephritis, and may result in delayed diagnosis or misdiagnosis. Correct and timely diagnosis would ensure adequate treatment in such patients. We report of a 22-month-old boy with acute glomerulonephritis coexistent with hemolytic anemia and idiopathic thrombocytopenia.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.22 no.1
• /
• pp.212-215
• /
• 2008

This study was designed to evaluate of oriental treatment on the sinsimtong With Acute glomerulonephritis Patient. We used oriental treatment for a patient who have the sinsimtong which has been caused by the Acute glomerulonephritis. After treated with oriental treatment, the symptoms of the Acute glomerulonephritis are disappeared. Form the above result, it could be suggest that oriental treatment have good effect on the sinsimtong With Acute glomerulonephritis Patient.

• Childhood Kidney Diseases
• /
• v.4 no.2
• /
• pp.154-160
• /
• 2000

The pathogenesis of IgA nephropathy and acute poststreptococcal glomerulonephritis is not fully understood. In the past, acute poststreptococcal glumerulonephritis was the most common cause of gross hematuria in children, but now IgA nephropathy is the most common one. We experienced two cases of acute poststreptococcal glomerulonephritis superimposing to IgA nephropathy in boys Case 1 had upper respiratory infection before elevation of anti-streptolysin O, generalized edema, gross hematuria and proteinuria. The complement levels were normal. Electron microscopic findings of renal biopsy at ten days after onset showed a few big subepithelial 'humps' and localized heavy subendothelial and mesangial deposits. Immunofluoroscopic findings revealed predominant IgA deposition in the mesangium. The electron microscopic findings were diagnostic of acute poststreptococcal glomerulonephritis On the other hand, immunoflorescence microscopic findings were compatible to IgA nephropathy. In case 2, the renal biopsy which was done 2 years after onset showed only finding of IgA nephropathy. To our knowledges, there has been kw reports of acute poststreptococcal glomerulonephritis superimposing to IgA nephropathy which was confirmed by renal biopsy. We report two cases of acute poststreptococcal glomerulonephritis superimposing: to IgA nephropathy with a brief review of the literatures.

• Childhood Kidney Diseases
• /
• v.7 no.2
• /
• pp.217-222
• /
• 2003

Chronic granulomatous disease(CGD) is a rare inherited disorder of phagocytic cells which results in a susceptibility to infections by catalase-positive bacteria and fungi, as well as granuloma formation. And acute poststreptococcal glomerulonephritis(APSGN) is one of the most common glomerular lesions of gross hematuria in children. We experienced a case of APSGN accompanied with CGD presenting with a liver granuloma.

• Childhood Kidney Diseases
• /
• v.8 no.2
• /
• pp.239-243
• /
• 2004

Acute poststreptococcal glomerulonephritis(APSGN) is the most common form of postinfectious glomerulonephritis, and acute pyelonephritis(APN) is the most severe form of urinary tract infection in childhood. However, the concurrence of two diseases is uncommon in the literature. We describe a case of APSGN accompanied with APN in a 5-year-old female who presented with fever, left flank pain, headache and facial edema. Urinalysis showed pyuria, microscopic hematuria, and mild proteinulra. Serial urine cultures grew Escherichia coli. ${^99m}$Tc-DMSA renal scan revealed a cortical defect in the upper pole of left kidney. She had a history of preceding pharyngitis, in addition, showed high blood pressure, high anti-streptolysin 0 titer, and low serum complement levels. The patient improved completely with supportive treatment, Including antibiotic and antihypertensive therapy. These findings suggested that APSGN and APN could be manifested simultaneously or be .superimposed on each other.

• Childhood Kidney Diseases
• /
• v.1 no.1
• /
• pp.73-78
• /
• 1997

The hypertensive encephalopathy is one of sudden convulsive cause in patients with acute post-streptococcal glomerulonephritis, but commonly, after the episode we can observe only mild to moderately hypertension in APSGN at ER. So these remains some question of what causes the convulsion in patients with APSGN. In this article, we report 3 cases of convulsion in APSGN with only moderate hypertension, the etiology of which proved to be due to hypertensive encephalopathy by the brain MRI. We believe that the brain MRI is a very useful test to diagnose the etiology of convulsion in APSGN and if brain edema in occipital lobe is detected by brain MRI, the convulsion would be due to hypertensive encephalopathy and the prognosis will be very good.

• Childhood Kidney Diseases
• /
• v.1 no.1
• /
• pp.82-85
• /
• 1997

The incidence of nephritis associated with Henoch-Sch nlein purpura varies, but glomerulonephritis consistently accounts for most of the associated morbidity and mortality. A very small number of Henoch-Sch nlein purpura develop rapidly progressive glomerulonephritis. A three-year old male patient who showed acute nephritic nephrotic syndrome developed abdominal pain, arthralgia and multiple purpurae on lower extremities later. Peritoneal dialysis was done at the 6th hospital day and continued for 7 months. Renal biopsy disclosed crescentic glomerulonephritis (with 81% crescent formation) and methylprednisolone pulse therapy was done. These days, his general condition is good, but serum creatinine levels are 1.2-1.3 mg/dL. This case was reviewed briefly with the literatures.

• Clinical and Experimental Pediatrics
• /
• v.59 no.3
• /
• pp.145-148
• /
• 2016

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal condition characterized by skin rash, fever, eosinophilia, and multiorgan involvement. Various drugs may be associated with this syndrome including carbamazepine, allopurinol, and sulfasalazine. Renal involvement in DRESS syndrome most commonly presents as acute kidney injury due to interstitial nephritis. An 11-year-old boy was referred to the Children's Hospital of Pusan National University because of persistent fever, rash, abdominal distension, generalized edema, lymphadenopathy, and eosinophilia. He previously received vancomycin and ceftriaxone for 10 days at another hospital. He developed acute kidney injury with nephrotic range proteinuria and hypocomplementemia. A subsequent renal biopsy indicated the presence of acute tubular necrosis (ATN) and late exudative phase of postinfectious glomerulonephritis (PIGN). Systemic symptoms and renal function improved with corticosteroid therapy after the discontinuation of vancomycin. Here, we describe a biopsy-proven case of severe ATN that manifested as a part of vancomycin-induced DRESS syndrome with coincident PIGN. It is important for clinicians to be aware of this syndrome due to its severity and potentially fatal nature.

• Childhood Kidney Diseases
• /
• v.10 no.2
• /
• pp.119-124
• /
• 2006

Purpose : The prognosis of acute poststreptococcal glomerulonephritis(APSGN) has been reported to be favorable. However, several studies have reported that patients with nephrotic range proteinuria in the acute phase or persistent proteinuria may progress to chronic renal failure. To elucidate this further, we analyzed the features of proteinuria and its prognosis in pediatric patients with APSGN. Methods : A total of 48 children with APSGN admitted to our hospital between Jan. 2000 and Dec. 2004 were included. After discharge from the hospital, patients were regularly followed up every month by clinical evaluations and laboratory tests including routine urinalysis and quantification of proteinuria. Results : Age of the patients ranged from 3 to 15 years(median 5.8 years) at the time of disease onset. Proteinuria was present in 34(70.8%) patients and 5 of them showed heavy proteinuria. Proteinuria normalized within one month in most patients(82.3%) and there was no one with proteinuria after 6 months. Cyclosporine A(5 mg/kg/day in two divided doses) was given to 3 patients with massive proteinuria that lasted longer than 2 months and the result was complete remission within 4 months. Conclusions : Our data indicated that the prognosis of APSGN during childhood is excellent. Children with severe proteinuria or subnormal renal function in poststreptococcal glomerulonephritis had favorable prognosis without chronic renal failure, and children with crescentic formation also had favorable prognosis. Three patients who continued to have heavy proteinuria for more than 2 months received cyclosporine A and remission of proteinuria was achieved within a couple of months.

• Clinical and Experimental Pediatrics
• /
• v.48 no.6
• /
• pp.606-613
• /
• 2005

Purpose : Acute poststreptococcal glomerulonephritis(APSGN) is a common form of glomerulonephritis in children. Most patients recover completely after the acute phase but a few patients have acute complications or progress to chronic renal disease. In recent years, the frequency of APSGN has been was decreasing but is still common in children. So we studied the clinical characteristics of APSGN from 1994 to 2003 and compared it with past studies. Methods : We studied 105 patients who were diagnosed with APSGN in the Department of Pediatrics, Asan Medical Center between January 1994 and December 2003, with a retrospective chart review. Results : The mean age was $8.5{\pm}2.6$ years. The male to female ratio was 2 : 1. Average annual incidence was $10.5{\pm}4.9$ most patients(60.0 percent) occurred from October to January. Edema was seen in 82 cases(78.1 percent), gross hematuria in 70 cases(66.7 percent), hypertension in 50 cases (47.6 percent) and oliguria in 22 cases(20.9 percent). Microscopic hematuria was seen in 105 cases (100 percent), positive ASO in 99 cases(94.2 percent), proteinuria in 67 cases(63.8 percent) and azotemia in 38 cases(36.2 percent). Serum complement 3(C3) level decreased in 96 cases and returned to normal within eight weeks in 70 patients(75.3 percent). Kidney biopsy was carried out in 22 cases. Most acute symptoms subsided within 2 weeks of onset. Conclusion : We concluded that there was no significant difference between clinical features of recent and past APSGN in children, and short term prognoses were excellent.