Cureus · 2025
Acute Post-streptococcal Glomerulonephritis in Children: A Moroccan Experience.
СтатьяНазвание и аннотация: Перевод в очереди
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Tizki Samira, Nassih Houda, Elqadiry Rabiy, Abourrahouat Aicha, Lahlou Laila, Aitsab Imane
Аннотация
BACKGROUND: Acute post-streptococcal glomerulonephritis (APSGN) is the most prevalent form of glomerulonephritis in children. It is caused by an immune-mediated glomerular injury, most commonly secondary to Group A β-hemolytic streptococcus. This study aims to describe the characteristics and outcomes of hospitalized children with APSGN.
METHODS: This was a retrospective descriptive study of 83 pediatric patients (<15 years) admitted to the pediatric nephrology department in the Mohamed VI Hospital in Marrakech with APSGN between January 2019 and December 2023, with a follow-up of one year. Children with acute glomerulonephritis not related to APSGN were excluded.
RESULTS: The mean age was 8.34 ± 3.58, and 69.9% (n = 58) were male. Among the 83 APSGN patients, 17 (20.4%) progressed to rapidly progressive glomerulonephritis (RPGN). The most often given presentations were hematuria (90.3%, n=75), edema (77.1%, n=64), hypertension (66.3%, n=55), and oliguria (12%, n=10). 15.6% (n=13) of the patients had an acute kidney injury (AKI). Nephrotic syndrome was found in 33.7% (n=28) of children, reduced C3 level in 84.3% (n=70), and elevated antistreptolysin O titer (ASOT) in 69.9% (n=58). Kidney biopsy was performed in 50.6% of children (n=42). 38.6% (n=32) of our patients required two anti‑hypertensives such as furosemide and nicardipine. Kidney replacement therapy was required for 6% (n=5) of patients, antibiotics for 36.1% (n=30), methylprednisolone pulses for 56.6% (n=47), and cyclophosphamide pulses for 20.4% (n=16). The outcome was favorable for all children, except for one girl with RPGN who developed a chronic kidney disease.
CONCLUSIONS: APSGN is still one of the most frequent causes of glomerulonephritis in Morocco. The main presenting features were hematuria and hypertension. Although the outcome of APSGN is good, sequential follow-up is necessary to detect long-term complications and prevent morbidity and mortality.
METHODS: This was a retrospective descriptive study of 83 pediatric patients (<15 years) admitted to the pediatric nephrology department in the Mohamed VI Hospital in Marrakech with APSGN between January 2019 and December 2023, with a follow-up of one year. Children with acute glomerulonephritis not related to APSGN were excluded.
RESULTS: The mean age was 8.34 ± 3.58, and 69.9% (n = 58) were male. Among the 83 APSGN patients, 17 (20.4%) progressed to rapidly progressive glomerulonephritis (RPGN). The most often given presentations were hematuria (90.3%, n=75), edema (77.1%, n=64), hypertension (66.3%, n=55), and oliguria (12%, n=10). 15.6% (n=13) of the patients had an acute kidney injury (AKI). Nephrotic syndrome was found in 33.7% (n=28) of children, reduced C3 level in 84.3% (n=70), and elevated antistreptolysin O titer (ASOT) in 69.9% (n=58). Kidney biopsy was performed in 50.6% of children (n=42). 38.6% (n=32) of our patients required two anti‑hypertensives such as furosemide and nicardipine. Kidney replacement therapy was required for 6% (n=5) of patients, antibiotics for 36.1% (n=30), methylprednisolone pulses for 56.6% (n=47), and cyclophosphamide pulses for 20.4% (n=16). The outcome was favorable for all children, except for one girl with RPGN who developed a chronic kidney disease.
CONCLUSIONS: APSGN is still one of the most frequent causes of glomerulonephritis in Morocco. The main presenting features were hematuria and hypertension. Although the outcome of APSGN is good, sequential follow-up is necessary to detect long-term complications and prevent morbidity and mortality.