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A Clinical Profile and Immediate Outcome of Acute Glomerulonephritis (AGN) in Hospitalized Children

Received: 26 July 2020     Accepted: 13 October 2020     Published: 4 November 2020
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Abstract

Introduction: Acute glomerulonephritis includes renal diseases in which immunologic mechanism triggers inflammation and proliferation of glomerular tissue that can result in damage to the basement membrane, proliferation of mesangium, capillary endothelium. Objectives: The objective of this study is to know the clinical profile and immediate outcome of acute glomerulonephritis in hospitalized children. Material & Methods: The study was done in Chittagong Medical College Hospital Pediatric Unit during the period of June 2007 to February 2008. All patients admitted with AGN, with or without complications were included in this study. Diagnostic criteria were scanty urine (infrequent and less than normal in amount as stated by the parents), swelling, high colored urine with or without albuminuria, no past history of similar attack and microscopic or naked eye haematuria. Criteria of discharge from the hospital were absence of puffiness and oedema, adequate urine formation, absence of heart failure and hypertensive encephalopathy. These were taken as clinical recovery. No long-term follow up was done. Results: Seventy-eight cases of acute glomerulonephritis (AGN) in children under 12 years of age were studied. Male to female ration 3:2. Scanty urine (84.0%), puffy face (88.5%) h, haematuria (80.0%), hypertension (82.5%), heart failure (11.5%) convulsion (14%) anuria (3.8%), RBC (92.3%), RBC cast (41%), albumin one (+) (52.6%) two + (14.1%) three + (14.1%), raised s. creatinine was (25.6%), blood urea (26.9%). Four patients were died. Among them three was due to hypertension and heart failure. One due to the development of acute renal failure. History of skin infection like scabies was present in 61.4% patient. Conclusion: Skin infection is the commonest cause of acute glomerulonephritis. Nephritic presentation (scanty urine oedema, haematuria, hypertension and heart failure) was the commonest mode of presentation. Immediate prognosis was excellent- Long term follow up is recommended.

Published in American Journal of Pediatrics (Volume 6, Issue 4)
DOI 10.11648/j.ajp.20200604.20
Page(s) 448-454
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Acute Glomerulonephritis, Skin Infection, Hospitalized Children, Pediatric, Haematuria

References
[1] Glassock RJ, Cohen AH, Adler SG: primary Glomerular disease Brenner Reetor’s: The Kidney, 5th edn. Saunders vol-11p-1392-1473.
[2] Rodriguez-Iturbe B, Batsford S. Pathogenesis of post-streptococcal glomerulonephritis a century after Clemens von Pirquet. Kidney Int. 2007; 71 (11): 1094-104.
[3] Batsford SR, Mezzano S, Mihatsch M, et al. Is the nephritogenic antigen in post-streptococcal glomerulonephritis py8rogenic exotoin B (SPE B) or GAPDH? Kidney Int. 2005; 68 (3): 1120-9.
[4] Derakhshan A, Hosseini Al, Hashemi G, Fallahzadeh MH. Spectrum of inpatient renal diseases in children, a report from Southern part of Islamic Republic of Iran. Saudi J Kidney Dis Transplant. 2004; 15 (1): 12.
[5] Chadban SJ, Atkins RC. Glomerulonephritis. Lancet 2005; 365: 1797.
[6] Carapetis JR, Steer AC, Mulholland EK, Weber M. The global burden of group A streptococcal disease. Lancet Infect Dis 2005; 5: 685.
[7] Rodriguez-Iturbe B. Postinfectious glomerulonephritis. Am J Kidney Dis 2000; 35: XLVI.
[8] Sanjad S, Tolaymat A, Whitworth J, Levin S. Acute glomerulonephritis in children: a review of 153 cases. South Med J 1977; 70: 1202.
[9] Cattran DC. Evidence-Based Recommendations for The Management of Glomerulonephritis. Introduction. Kidney IntSuppl 1999 Jun; 70: S1-2. 12.
[10] Steer AC, Danchin MH, Carapetis JR. Group A streptococcal infection in children. J Paediatr Child Health 2007; 43: 203-213.
[11] Gumus, H. Per, S. Kumandas¸, and A. Yikilmaz, “Reversible posterior leukoencephalopathy syndrome in childhood: report of nine cases and review of the literature,” Neurological Sciences, vol. 31, no. 2, pp. 125–131, 2010.
[12] T. M. Eison, B. H. Ault, D. P. Jones, R. W. Chesney, and R. J. Wyatt, “Post-streptococcal acute glomerulonephritis in children: clinical features and pathogenesis,” Pediatric Nephrology, vol. 26, pp. 165–180, 2011.
[13] R. Bogdanovic, Henoch-Schönlein purpura, “Nephritis in children: risk factors, prevention and treatment,” Acta Paediatrica, vol. 98, no. 12, pp. 1882–1889, 2009.
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    A. N. M. Shahidul Islam Bhuiyan, Zahangir Alam, Khondaker Zahirul Hasan, Md Mostafa Zaman, Md Zakaria. (2020). A Clinical Profile and Immediate Outcome of Acute Glomerulonephritis (AGN) in Hospitalized Children. American Journal of Pediatrics, 6(4), 448-454. https://doi.org/10.11648/j.ajp.20200604.20

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    ACS Style

    A. N. M. Shahidul Islam Bhuiyan; Zahangir Alam; Khondaker Zahirul Hasan; Md Mostafa Zaman; Md Zakaria. A Clinical Profile and Immediate Outcome of Acute Glomerulonephritis (AGN) in Hospitalized Children. Am. J. Pediatr. 2020, 6(4), 448-454. doi: 10.11648/j.ajp.20200604.20

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    AMA Style

    A. N. M. Shahidul Islam Bhuiyan, Zahangir Alam, Khondaker Zahirul Hasan, Md Mostafa Zaman, Md Zakaria. A Clinical Profile and Immediate Outcome of Acute Glomerulonephritis (AGN) in Hospitalized Children. Am J Pediatr. 2020;6(4):448-454. doi: 10.11648/j.ajp.20200604.20

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  • @article{10.11648/j.ajp.20200604.20,
      author = {A. N. M. Shahidul Islam Bhuiyan and Zahangir Alam and Khondaker Zahirul Hasan and Md Mostafa Zaman and Md Zakaria},
      title = {A Clinical Profile and Immediate Outcome of Acute Glomerulonephritis (AGN) in Hospitalized Children},
      journal = {American Journal of Pediatrics},
      volume = {6},
      number = {4},
      pages = {448-454},
      doi = {10.11648/j.ajp.20200604.20},
      url = {https://doi.org/10.11648/j.ajp.20200604.20},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20200604.20},
      abstract = {Introduction: Acute glomerulonephritis includes renal diseases in which immunologic mechanism triggers inflammation and proliferation of glomerular tissue that can result in damage to the basement membrane, proliferation of mesangium, capillary endothelium. Objectives: The objective of this study is to know the clinical profile and immediate outcome of acute glomerulonephritis in hospitalized children. Material & Methods: The study was done in Chittagong Medical College Hospital Pediatric Unit during the period of June 2007 to February 2008. All patients admitted with AGN, with or without complications were included in this study. Diagnostic criteria were scanty urine (infrequent and less than normal in amount as stated by the parents), swelling, high colored urine with or without albuminuria, no past history of similar attack and microscopic or naked eye haematuria. Criteria of discharge from the hospital were absence of puffiness and oedema, adequate urine formation, absence of heart failure and hypertensive encephalopathy. These were taken as clinical recovery. No long-term follow up was done. Results: Seventy-eight cases of acute glomerulonephritis (AGN) in children under 12 years of age were studied. Male to female ration 3:2. Scanty urine (84.0%), puffy face (88.5%) h, haematuria (80.0%), hypertension (82.5%), heart failure (11.5%) convulsion (14%) anuria (3.8%), RBC (92.3%), RBC cast (41%), albumin one (+) (52.6%) two + (14.1%) three + (14.1%), raised s. creatinine was (25.6%), blood urea (26.9%). Four patients were died. Among them three was due to hypertension and heart failure. One due to the development of acute renal failure. History of skin infection like scabies was present in 61.4% patient. Conclusion: Skin infection is the commonest cause of acute glomerulonephritis. Nephritic presentation (scanty urine oedema, haematuria, hypertension and heart failure) was the commonest mode of presentation. Immediate prognosis was excellent- Long term follow up is recommended.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - A Clinical Profile and Immediate Outcome of Acute Glomerulonephritis (AGN) in Hospitalized Children
    AU  - A. N. M. Shahidul Islam Bhuiyan
    AU  - Zahangir Alam
    AU  - Khondaker Zahirul Hasan
    AU  - Md Mostafa Zaman
    AU  - Md Zakaria
    Y1  - 2020/11/04
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ajp.20200604.20
    DO  - 10.11648/j.ajp.20200604.20
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 448
    EP  - 454
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20200604.20
    AB  - Introduction: Acute glomerulonephritis includes renal diseases in which immunologic mechanism triggers inflammation and proliferation of glomerular tissue that can result in damage to the basement membrane, proliferation of mesangium, capillary endothelium. Objectives: The objective of this study is to know the clinical profile and immediate outcome of acute glomerulonephritis in hospitalized children. Material & Methods: The study was done in Chittagong Medical College Hospital Pediatric Unit during the period of June 2007 to February 2008. All patients admitted with AGN, with or without complications were included in this study. Diagnostic criteria were scanty urine (infrequent and less than normal in amount as stated by the parents), swelling, high colored urine with or without albuminuria, no past history of similar attack and microscopic or naked eye haematuria. Criteria of discharge from the hospital were absence of puffiness and oedema, adequate urine formation, absence of heart failure and hypertensive encephalopathy. These were taken as clinical recovery. No long-term follow up was done. Results: Seventy-eight cases of acute glomerulonephritis (AGN) in children under 12 years of age were studied. Male to female ration 3:2. Scanty urine (84.0%), puffy face (88.5%) h, haematuria (80.0%), hypertension (82.5%), heart failure (11.5%) convulsion (14%) anuria (3.8%), RBC (92.3%), RBC cast (41%), albumin one (+) (52.6%) two + (14.1%) three + (14.1%), raised s. creatinine was (25.6%), blood urea (26.9%). Four patients were died. Among them three was due to hypertension and heart failure. One due to the development of acute renal failure. History of skin infection like scabies was present in 61.4% patient. Conclusion: Skin infection is the commonest cause of acute glomerulonephritis. Nephritic presentation (scanty urine oedema, haematuria, hypertension and heart failure) was the commonest mode of presentation. Immediate prognosis was excellent- Long term follow up is recommended.
    VL  - 6
    IS  - 4
    ER  - 

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Author Information
  • Department of Paediatrics, Cumilla Medical College, Cumilla, Bangladesh

  • Department of Paediatrics, Abdul Malek Ukil Medical College, Noakhali, Bangladesh

  • Department of Paediatrics, Abdul Malek Ukil Medical College, Noakhali, Bangladesh

  • Department of Paediatrics, M Abdur Rahim Medical College, Dinajpur (MARMC), Bangladesh

  • Department of Paediatrics, Sunamgong Sadar Hospital, Sunamgong, Sylhet, Bangladesh

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