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International Journal of Nephrology
Volume 2016, Article ID 5163065, 5 pages
http://dx.doi.org/10.1155/2016/5163065
Research Article

Acute Kidney Injury and Atypical Features during Pediatric Poststreptococcal Glomerulonephritis

Division of Nephrology, Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH, USA

Received 22 February 2016; Revised 15 July 2016; Accepted 28 July 2016

Academic Editor: Frank Park

Copyright © 2016 Rose M. Ayoob and Andrew L. Schwaderer. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The most common acute glomerulonephritis in children is poststreptococcal glomerulonephritis (PSGN) usually occurring between 3 and 12 years old. Hypertension and gross hematuria are common presenting symptoms. Most PSGN patients do not experience complications, but rapidly progressive glomerulonephritis and hypertensive encephalopathy have been reported. This paper reports 17 patients seen in 1 year for PSGN including 4 with atypical PSGN, at a pediatric tertiary care center. Seventeen children (11 males), mean age of 8 years, were analyzed. Ninety-four percent had elevated serum BUN levels and decreased GFR. Four of the hospitalized patients had complex presentations that included AKI along with positive ANA or ANCAs. Three patients required renal replacement therapy and two were thrombocytopenic. PSGN usually does not occur as a severe nephritis. Over the 12-month study period, 17 cases associated with low serum albumin in 53%, acute kidney injury in 94%, and thrombocytopenia in 18% were treated. The presentation of PSGN may be severe and in a small subset have associations similar to SLE nephritis findings including AKI, positive ANA, and hematological anomalies.