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Journal of the Korean Society of Pediatric Nephrology 2000;4(2): 154-160.
IgA 신병증에 병발한 급성 연쇄상구균 감염후 사구체신염
김영균, 이준호, 한혜원, 하일수, 정해일, 최용
1인제대학교 의과대학 서울백병원 소아과학교실
2서울대학교 의과대학 소아과학교실
3서울대학교 의과대학 소아과학교실
4서울대학교 의과대학 소아과학교실
5서울대학교 의과대학 소아과학교실
6서울대학교 의과대학 소아과학교실
Two Cases of Acute Poststreptococcal Glomerulonephritis Superimposing to IgA Nephropathy
Young Kyoun Kim, Jun Ho Lee, Hyewon Hahn, Il Soo Ha, Hae Il Cheong, Yong Choi
1Department of Pediatrics, College of Medicine, Inje University, Seoul Paik Hospital
2Department of Pediatrics, College of Medicine, Seoul National University
3Department of Pediatrics, College of Medicine, Seoul National University
4Department of Pediatrics, College of Medicine, Seoul National University
5Department of Pediatrics, College of Medicine, Seoul National University
6Department of Pediatrics, College of Medicine, Seoul National University
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ABSTRACT
The pathogenesis of IgA nephropathy and acute poststreptococcal glomerulonephritis is not fully understood. In the past, acute poststreptococcal glumerulonephritis was the most common cause of gross hematuria in children, but now IgA nephropathy is the most common one. We experienced two cases of acute poststreptococcal glomerulonephritis superimposing to IgA nephropathy in boys Case 1 had upper respiratory infection before elevation of anti-streptolysin O, generalized edema, gross hematuria and proteinuria. The complement levels were normal. Electron microscopic findings of renal biopsy at ten days after onset showed a few big subepithelial 'humps' and localized heavy subendothelial and mesangial deposits. Immunofluoroscopic findings revealed predominant IgA deposition in the mesangium. The electron microscopic findings were diagnostic of acute poststreptococcal glomerulonephritis On the other hand, immunoflorescence microscopic findings were compatible to IgA nephropathy. In case 2, the renal biopsy which was done 2 years after onset showed only finding of IgA nephropathy. To our knowledges, there has been kw reports of acute poststreptococcal glomerulonephritis superimposing to IgA nephropathy which was confirmed by renal biopsy. We report two cases of acute poststreptococcal glomerulonephritis superimposing: to IgA nephropathy with a brief review of the literatures.
Key words: Acute poststreptococcal glomerulonephritis | IgA Nephropathy | Superimposing
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