Acute nephritic syndrome with gross hematuria
o Smoky colored
o Tea colored or coca cola colored
Nephritic active urinary sediment
An average of ten days after pharyngitis or two weeks after skin infection with nephritogenic strain of group A beta-hemolytic streptococcus is needed prior to post-streptococcal glomerulonephritis.
„X Low complement
o Low C3 and CH50
o C4 level is normal
o Positive titers
„X Anti DNAse
Post streptococcal GN is diagnosed on clinical and serological grounds without biopsy especially in children with typical history. It is an immune complex disease. Light microscopy shows diffuse proliferative glomerulonephritis and immunofluorescence shows diffuse granular deposits of IgG and C3. Electron microscopy shows large electron dense immune deposits that are dome shaped in subendothelial, subepithelial, and mesangial areas.
Other important post-infectious glomerulonephritis include acute and subacute bacterial endocarditis, shunt nephritis which is secondary to infection of ventriculoatrial shunts inserted in childhood for treatment of hydrocephalus, glomerulonephritis secondary to chronic suppurative infections, and visceral abscesses.
„X Supportive and symptomatic
o Antihypertensive medications
„X Steroids are used if it becomes rapidly progressive
It is usually a self-limited disease. Recovery occurs in 3 - 4 weeks. Proteinuria and hematuria can persist for a year. Adults are at a higher risk of residual renal impairment compared to children with post-streptococcal glomerulonephritis.