Location
Moultrie, GA
Start Date
7-5-2025 1:00 PM
End Date
7-5-2025 4:00 PM
Description
Post-streptococcal glomerulonephritis (PSGN) is a major cause of acute kidney injury (AKI) in children. It follows a Group-A Streptococcal skin or throat infection characterized by complement activation and immune complex deposition, leading to glomerular inflammation and impaired renal function. While PSGN typically presents with hematuria, proteinuria, hypertension, and edema, cases with atypical presentations and no recent history of Strep infection, can delay diagnosis (Dhakal et al., 2023).
We report the case of a 16-year-old female with AKI and acute gastroenteritis with no history of sick contacts. Specifically, she presented with a 2-day history of weakness, nausea, vomiting, and 8 hours of anuria. Viral swabs were positive for Enterovirus/Rhinovirus and negative for Group-A Streptococcus. Initial urinalysis (UA) revealed elevated WBC, and RBC, as well as muddy brown casts consistent with Acute Tubular Necrosis (ATN). Subsequent serologic testing revealed elevated anti-streptolysin O (ASO) titers, confirming a preceding streptococcal infection. A diagnosis of PSGN was established, with AKI attributed to immune-mediated glomerular injury. The patient was treated with supportive care, and antibiotics and referred to nephrology for follow-up. This case highlights the variable presentations of PSGN and emphasizes the importance of considering post-infectious glomerulonephritis in pediatric patients with AKI. Prompt recognition and supportive management are crucial for optimizing renal recovery and preventing long-term sequelae.
Embargo Period
6-3-2025
Included in
Acute kidney injury secondary to post-streptococcal glomerulonephritis in a pediatric patient
Moultrie, GA
Post-streptococcal glomerulonephritis (PSGN) is a major cause of acute kidney injury (AKI) in children. It follows a Group-A Streptococcal skin or throat infection characterized by complement activation and immune complex deposition, leading to glomerular inflammation and impaired renal function. While PSGN typically presents with hematuria, proteinuria, hypertension, and edema, cases with atypical presentations and no recent history of Strep infection, can delay diagnosis (Dhakal et al., 2023).
We report the case of a 16-year-old female with AKI and acute gastroenteritis with no history of sick contacts. Specifically, she presented with a 2-day history of weakness, nausea, vomiting, and 8 hours of anuria. Viral swabs were positive for Enterovirus/Rhinovirus and negative for Group-A Streptococcus. Initial urinalysis (UA) revealed elevated WBC, and RBC, as well as muddy brown casts consistent with Acute Tubular Necrosis (ATN). Subsequent serologic testing revealed elevated anti-streptolysin O (ASO) titers, confirming a preceding streptococcal infection. A diagnosis of PSGN was established, with AKI attributed to immune-mediated glomerular injury. The patient was treated with supportive care, and antibiotics and referred to nephrology for follow-up. This case highlights the variable presentations of PSGN and emphasizes the importance of considering post-infectious glomerulonephritis in pediatric patients with AKI. Prompt recognition and supportive management are crucial for optimizing renal recovery and preventing long-term sequelae.