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Journal of the Korean Society of Pediatric Nephrology 2008;12(2): 157-163. doi: https://doi.org/10.3339/jkspn.2008.12.2.157
소아에서 연쇄상 구균 감염 후 급성 사구체 신염의 임상양상의 변화
최병호, 추미애, 홍은희, 황현희, 조민현, 고철우
1경북대학교 의과대학 소아과학교실
2경북대학교 의과대학 소아과학교실
3경북대학교 의과대학 소아과학교실
4경북대학교 의과대학 소아과학교실
5경북대학교 의과대학 소아과학교실
6경북대학교 의과대학 소아과학교실
Changes of Clinical Findings of Acute Poststreptococcal Glomerulonephritis
Byung-Ho Choi, Mi-Ae Chu, Eun-Hui Hong, Hyun-Hee Hwang, Min-Hyun Cho, Cheol-Woo Ko
1Department of Pediatrics, Kyungpook National University, School of Medicine
2Department of Pediatrics, Kyungpook National University, School of Medicine
3Department of Pediatrics, Kyungpook National University, School of Medicine
4Department of Pediatrics, Kyungpook National University, School of Medicine
5Department of Pediatrics, Kyungpook National University, School of Medicine
6Department of Pediatrics, Kyungpook National University, School of Medicine
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ABSTRACT
Purpose : Several studies have reported the recent increase in the incidence of acute poststreptococcal glomerulonephritis(APSGN). The objective of this study is to see changes of clinical findings/manifwstation in children with APSGN.
Methods : Medical records of 63 children who were diagnosed with APSGN in the deparment of Pediatrics, Kyungpook National University Hospital, between January 1992 and December 2006 were reviewed retrospectively. We analyzed various clinical characteristics such as age, sex, degrees of proteinuria, degrees of hematuria, and presence or absence of histories of systemic antibiotic use in children with APSGN, and compared the children with APSGN who were diagnosed between 1992 and 2000 to those who were diagnosed between 2001 and 2006.
Results : Age of the patients ranged from 2-14 years(median 7.11 years) at the time of disease onset. Study patients consisted of 41 boys and 22 girls. APSGN followed infection of the throat in 87% of cases. Patient developed an acute nephritic syndrome 12 days after an antecedent streptococcal pharyngitis. Forty patients presented with gross hematuria. Fortyone patients had hypertension at the time of diagnosis. Hypertension disappeared within 7.8$pm$8.2 days, gross hematuria within 11.3$pm$17.2 days and microscopic hematuria within 3.5$pm$3.9 months from the disease onset. Patients in 2001-2006 had significantly higher increase of antistreptolysin O(ASO) titer. However, no significant differences in clinical characteristics were observed. Age, sex, severity of proteinuria, gross or microscopic hematuria, antibiotic therapy did not affect the clinical manifestations of glomerulonephritis. In other words, hypertension, duration of hematuria, recovery of serum C3 level are not different between the two time periods.
Conclusion : Our data indicates that patients in 2001-2006 had significantly higher level of ASO titer. However, they did not show significant clinical differences. To evaluate the causes of the resurgence of APSGN, a national epidemic is needed.
Key words: Voiding cystourethrography | Urinary tract infection | Infant
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