A case of extrarenal symptomatic acute poststreptococcal glomerulonephritis with hypertension, edema and severe hepatosplenomegaly

Abstract

Acute poststreptococcal glomerulonephritis (APSGN) is the most common postinfectious glomerulonephritis in childhood. In some cases, urinary findings are clear or very subtle. Such cases are known as extrarenal symptomatic APSGN.

A 9-year-old boy had suffered from abdominal distention and loss of appetite for 3 days, and came to our hospital. Physical examination revealed body weight gain, hypertension, edema, and hepatosplenomegaly. Although urinary findings were almost clear and there were no symptoms of antecedent infection, laboratory data showed elevated antistreptolysin O level and hypocomplementemia, so we diagnosed extrarenal symptomatic APSGN. Supportive care was provided, and the patient was discharged without any lasting effects on the 11th hospital day. At subsequent examinations, neither hypocomplementemia nor any recurrences of glomerulonephritis have been seen.

Extrarenal symptomatic APSGN is one of the important differential diagnoses involving edema and hypertension in children.