Post-streptococcal acute glomerulonephritis in children: clinical features and pathogenesis

Abstract

Abstract Post-streptococcal acute glomerulonephritis (PSAGN) is one of the most important and intriguing conditions in the discipline of pediatric nephrology. Although the eventual outcome is excellent in most cases, PSAGN remains an important cause of acute renal failure and hospitalization for children in both developed and underdeveloped areas. The purpose of this review is to describe both the typical and less common clinical features of PSAGN, to outline the changes in the epidemiology of PSAGN over the past 50 years, and to explore studies on the pathogenesis of the condition with an emphasis on the search for the elusive nephritogenic antigen. Keywords Acute glomerulonephritis . Group A beta-hemolytic streptococcus . Nephritogenic Historical perspective In 1812, Wells described the clinical features of acute nephritis that included a latent period between scarlatina and development of edema and urine that contained both a red substance and a coagulable substance (protein) The association between β-hemolytic streptococcal infection and acute glomerulonephritis was noted by Longcope et al., who stated that "no evidence could be obtained...that the streptococcus caused the glomerular nephritis by actual invasion of the kidney, for blood cultures and urine cultures were negative" By 1940 serologic findings of anti-streptococcal antibodies Dedication This review is dedicated to the memory of Shane Roy III . Dr. Roy was the first pediatric nephrologist in Tennessee. His scholarly interest in post-streptococcal acute glomerulonephritis spanned his 40-year career in Memphis, resulting in seminal clinical observations on the condition