Clinical Profile and Outcome of Acute Post-Streptococcal Glomerulonephritis in Children

Acute glomerulonephritis (AGN) is a common disease of children over 5 years of age. 36 children with acute post-streptococcal glomerulonephritis were studied prospectively in Comilla 250 bed modern hospital from March, 1992 to February 1993. There were 20 (55.5%) male and 16 (44.5%) female subjects. Age of the children were from 4–12 years (mean 7.6 years). Previous or present skin infections accounted for 89% of the cases of AGN. Puffiness of the face, generalized swelling of the body and scanty high coloured urine and fever were the common complaints. Dependent oedema (100%), hypertension (89%), pallor (61%), impetigo (39%), tachypnoea (16.6%) & evidences of heart failure (16.6%) were the important clinical findings. High ASO titre was evident in 16 cases (88.9%) out of 18 cases done. The patients were managed by penicillin, frusemide, antihypertensive, digoxin (when needed) and by restriction of fluid, protein & salt. The duration of hospital stay ranged from 7–19 days (mean 9.5 days). 3 patients died in the hospital: 2 on the same day of hospitalization due to acute left ventricular failure and one at the 10th day due to hypertensive encephalopathy. Other 33 children recovered. None of them showed any complication at the end of 3 months after discharge. Early detection of treatment of skin infection can abort many attacks of AGN in children.