Disease Information for Glomerulonephritis, postinfectious: Definition

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  • Acute glomerulonephritis refers to a specific set of renal diseases in which an immunologic mechanism triggers inflammation and proliferation of glomerular tissue; back pain and hematuria, which lead to oliguria or anuria; Acute glomerulonephritis is currently described as a clinical syndrome that frequently manifests as a sudden onset of hematuria, proteinuria, and red cell casts; This clinical picture often is accompanied by hypertension, edema, and impaired renal function; Glomerular lesions in acute glomerulonephritis are the result of glomerular deposition or in situ formation of immune complexes; On gross appearance, the kidneys may be enlarged up to 50%; Histopathologic changes include swelling of the glomerular tufts and infiltration with polymorphonucleocyte; Immunofluorescence reveals deposition of immunoglobulins and complement; With the exception of poststreptococcal glomerulonephritis, the exact triggers for the formation of the immune complexes are unclear; In streptococcal infection, involvement of derivatives of streptococcal proteins has been reported; A streptococcal neuramidase may alter host immunoglobulin G (IgG); IgG combines with host antibodies; IgG/anti-IgG immune complexes are formed and then collect in the glomeruli; In addition, elevations of antibody titers to other antigens, such as antistreptolysin O or antihyaluronidase, DNAase-B, and streptokinase, provide evidence of a recent streptococcal infection; subclinical nature of the disease in more than one half the affected population; Despite sporadic outbreaks, incidence of poststreptococcal glomerulonephritis has fallen over the last few decades in most western countries; this remains much more common in regions such as Africa, the Caribbean, India, Pakistan, Malaysia, Papua New Guinea, and South America; Most epidemic cases follow a course ending in complete patient recovery (as many as 100%); Sporadic cases of acute nephritis often progress to a chronic form; This progression occurs in as many as 30% of adult and 10% of pediatric patients; The mortality rate of acute glomerulonephritis pediatric patients, has been reported at 0-7%; male-to-female ratio of 2:1 and aged 5-15 years; Acute nephritis may occur at any age, including infancy

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