Answer 79
Acute post-streptococcal glomerulonephritis of childhood:
True a. occurs after cellulitis but not pharyngitis
False b. should be treated with steroids
False c. is fatal in about half of all cases
False d. is usually crescentic on microscopy
False e. usually presents with acute renal failure
T F F F F
In the tropics it probably occurs more commonly after infected skin lesions but glomerulonephritis following a streptococcal pharyngitis is not uncommon. The streptococcus is classically group A beta-haemolytic (type 12).
The usual histology is diffuse proliferative glomerulonephritis.
Patients present with an acute nephritic illness.
The prognosis is good.
Management is aimed at controlling hypertension and treating pulmonary oedema. Dialysis is occasionally required but return to normal renal function is the rule.
Steroids and immunosuppressives are not required.
Generally C3 is reduced and anti-streptolysin titres are raised.
