acute proliferative glomerulonephritis

Acute Proliferative Glomerulonephritis (APGN) Overview

Acute proliferative glomerulonephritis, also known as postinfectious glomerulonephritis (PIGN), is a disorder of the small blood vessels in the kidney. It is characterized by inflammation and proliferation of the glomeruli, which are the filtering units of the kidneys.

Causes and Risk Factors

APGN is often triggered by bacterial infections, particularly those caused by Streptococcus bacteria types 12, 4, and 1. These infections can occur in various parts of the body, such as the skin or throat. The condition is also known to be a complication of streptococcal pharyngitis.

Symptoms

The symptoms of APGN typically appear suddenly and may include:

• Edema (swelling) of the face, hands, and feet
• Hematuria (blood in the urine)
• Proteinuria (excess protein in the urine)
• Hypertension (high blood pressure)

Complications

If left untreated or not managed properly, APGN can lead to complications such as:

• Acute kidney failure
• Chronic kidney disease

Treatment and Management

The treatment for APGN depends on the severity of the condition. Mild cases may be managed with supportive care, while more severe cases may require hospitalization and dialysis. Antibiotics are often prescribed to treat underlying bacterial infections.

Prognosis

With prompt and proper treatment, most people with APGN can recover fully. However, some individuals may experience long-term kidney damage or other complications.

References:

• [9] Acute proliferative glomerulonephritis is a disorder of the small blood vessels of the kidney.It is a common complication of bacterial infections, typically skin infection by Streptococcus bacteria types 12, 4 and 1 but also after streptococcal pharyngitis, for which that 'Acute proliferative glomerulonephritis' is used as an alternative name.
• [10] Acute proliferative glomerulonephritis (APGN) is a condition characterized by inflammation and proliferation of the glomeruli in the kidneys.

Common Signs and Symptoms of Acute Proliferative Glomerulonephritis

Acute proliferative glomerulonephritis is a disorder that affects the small blood vessels of the kidney, leading to various signs and symptoms. Here are some common ones:

• Blood in Urine: One of the most noticeable symptoms is the presence of blood in urine, which can make it appear dark, tea-colored, or cloudy [8]. This is due to the glomeruli leaking blood into the urine.
• Decreased Urine Output: People with acute proliferative glomerulonephritis may experience decreased urine output, or even no urine production at all [8].
• Swelling (Edema): Swelling of the face, hands, feet, and belly can occur due to fluid buildup in the body [11].
• High Blood Pressure: Elevated blood pressure is a common symptom, which can be a sign of kidney damage [6][9].
• Fatigue: Feeling tired or weak is another symptom that people may experience [11].
• Fever: Some individuals may develop fever or flu-like symptoms as their body responds to the infection [3][12].

Other Possible Symptoms

In some cases, people with acute proliferative glomerulonephritis may also experience:

• Nausea and vomiting
• Abdominal discomfort
• Generalized weakness
• Malaise

It's essential to note that not everyone will exhibit all of these symptoms. Some individuals might only have mild proteinuria or hematuria, while others may experience more severe signs and symptoms.

References

[3] Context 3: Acute (sudden) glomerulonephritis can be temporary and reversible, or it may get worse. [6] Context 6: The urine is usually dark, frothy, or scanty, and the blood pressure may be high. [8] Context 8: Symptoms · Blood in the urine

Acute proliferative glomerulonephritis can be diagnosed using various tests, which are aimed at assessing kidney function and identifying the underlying cause of the condition.

Blood Tests

• Blood urea nitrogen (BUN), serum creatinine, and serum electrolytes (especially serum potassium) are measured to evaluate kidney function [6].
• A complete blood count (CBC) may be performed to rule out other conditions that could be causing the symptoms [6].

Urine Tests

• Urine tests can detect red and white blood cells, infection, or too much protein in the urine [4].
• Red blood cell casts are best detected in first, early-morning urine specimens examined by the physician immediately after the patient voids [8].

Imaging Studies

• Ultrasound of the kidney may be performed to visualize the kidneys and assess their function [4].

Renal Biopsy

• A renal biopsy is a definitive diagnostic test for acute proliferative glomerulonephritis, which involves taking a small sample of kidney tissue for examination under a microscope [7].
• The biopsy can help confirm the diagnosis and determine the level of kidney damage [7].

Other Tests

• The streptozyme test may be used to measure multiple streptococcal antibodies: antistreptolysin, antihyaluronidase, etc. [3].
• Blood cultures and blood tests that help identify the organisms causing infections other than strep throat may be performed to confirm the diagnosis [11].

It's worth noting that a kidney biopsy is usually not necessary for initial diagnosis, but it can be helpful in confirming the diagnosis and determining the level of kidney damage [7].

Treatment Options for Acute Proliferative Glomerulonephritis

Acute proliferative glomerulonephritis (APGN) is a type of kidney disease characterized by inflammation and proliferation of the glomeruli. While there is no specific treatment for APGN, various medications can help manage symptoms and slow disease progression.

Medications Used in Treatment

• Antimicrobials: Patients with evidence of a streptococcal infection should receive a course of antibiotic therapy to destroy any remaining bacteria in the body [7][8].
• Corticosteroids: Anti-inflammatory therapy with corticosteroids may be recommended to reduce inflammation and swelling in the kidneys [13].
• Immunosuppressants: Medicines called immunosuppressants, such as ACE inhibitors/ARBs, can be prescribed if APGN is caused by problems with the immune system [6].

Other Treatment Approaches

• Supportive care: The treatment for acute glomerulonephritis is primarily supportive: diuretics to reduce edema and antihypertensive drugs to reduce elevated blood pressure [13].
• Plasmapheresis: This procedure may be included in the treatment plan for certain types of APGN, such as double-positive antibody crescentic glomerulonephritis [15].

Important Considerations

It's essential to note that treatment options and approaches may vary depending on the underlying cause of APGN, individual patient factors, and disease severity. A healthcare professional should be consulted to determine the best course of treatment for a specific case.

References: [6] by AM Kazi · 2023 · Cited by 26 — IgA nephropathy: ACE inhibitors/ARBs (3 to 6 months) are used as they reduce proteinuria. [7] by P Rawla · 2022 · Cited by 56 — Pharmacological Therapy · Antimicrobials: Patients with evidence of a streptococcal infection should receive a course of antibiotic therapy, and ... [8] Aug 28, 2024 - Treatment for double-positive antibody crescentic glomerulonephritis follows the same approach as for pauci-immune glomerulonephritis, but plasmapheresis should be included. [13] The treatment for acute glomerulonephritis is primarily supportive: diuretics to reduce the edema and antihypertensive drugs to reduce elevated blood pressure. Anti-inflammatory therapy with corticosteroids ... [15] Treatment for double-positive antibody crescentic glomerulonephritis follows the same approach as for pauci-immune glomerulonephritis, but plasmapheresis should be included.

Differential Diagnosis of Acute Proliferative Glomerulonephritis

Acute proliferative glomerulonephritis (APGN) is a disorder of the small blood vessels of the kidney, often triggered by bacterial infections. When diagnosing APGN, it's essential to consider other potential causes that may present with similar symptoms. The differential diagnosis for APGN includes:

• Postinfectious glomerulonephritis (PIGN): A condition caused by streptococcal infections, which can lead to inflammation of the kidney's glomeruli.
• Membranoproliferative glomerulonephritis: A type of kidney disease characterized by changes in the glomerular basement membrane and mesangial cells.
• IgA nephropathy: A condition where IgA antibodies accumulate in the kidneys, leading to inflammation and damage.
• Nephrotic syndrome: A collection of symptoms including severe swelling, particularly in your legs and feet, due to kidney damage.

These conditions can be challenging to distinguish from APGN, as they may present with similar clinical features. However, a thorough evaluation, including serologic and pathologic examination, is crucial for accurate diagnosis (1, 3, 5, 6).

References:

[1] - The differential diagnosis includes most other types of childhood glomerulonephritides. These include IgA nephropathy, membranoproliferative glomerulonephritis ... [Search Result 5] [3] - Acute proliferative glomerulonephritis is a disorder of the small blood vessels of the kidney.It is a common complication of bacterial infections, typically skin infection by Streptococcus bacteria types 12, 4 and 1 but also after streptococcal pharyngitis, for which it is also known as postinfectious glomerulonephritis (PIGN) or poststreptococcal glomerulonephritis (PSGN). [Search Result 3] [5] - Oct 31, 2023 — The differential diagnosis includes most other types of childhood glomerulonephritides. These include IgA nephropathy, membranoproliferative glomerulonephritis ... [Search Result 5] [6] - Feb 13, 2019 — Differential Diagnosis · Anhidrosis or decreased sweating · Fatigue · Angiokeratomas · Burning pain of the extremities · Corneal opacities. [Search Result 9]