Poststreptococcal glomerulonephritis with pulmonary edema presenting as respiratory distress

Chih Yung Chiu, Yhu Chering Huang, Kin Sun Wong, Shao Hsuan Hsia, Chi Jen Lin, Tzou Yien Lin

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Acute poststreptococcal glomerulonephritis (PSGN) is characterized by an abrupt onset of edema, hypertension, and hematuria. Although the association of pulmonary edema with acute glomerulonephritis has been established, it is uncommon for children with PSGN to present with respiratory distress due to pulmonary edema. We encountered six such patients, aged 6-10 years, during a 10-month period. The demographic data, clinical manifestations, laboratory data, radiographic pictures, and clinical courses were collected. All patients presented to the primary pediatricians with dyspnea and alveolar infiltrates with bilateral pleural effusions on plain chest radiographs that were misinterpreted as pneumonia initially. The diagnosis of PSGN was delayed until the awareness of the presence of pulmonary edema complicating PSGN. Subsequent urinalysis and blood pressure measurement all showed microscopic hematuria and hypertension. Elevated serum antistreptolysin O titers and depressed serum complement C3 levels confirmed the diagnosis of PSGN. Two patients progressed to respiratory failure because of a delayed diagnosis of PSGN. All patients recovered without sequelae following appropriate diuresis and antihypertensive therapy. We conclude that in preschool and school-age children who present with dyspneic respirations and a chest radiograph showing radiographic features of pulmonary edema, proper evaluation including blood pressure recording and urinalysis should be performed immediately. Prompt diagnosis and early therapy of PSGN may avoid mortality and unnecessary therapeutic intervention.

Original languageEnglish
Pages (from-to)1237-1240
Number of pages4
JournalPediatric Nephrology
Volume19
Issue number11
DOIs
Publication statusPublished - Nov 2004
Externally publishedYes

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Keywords

  • Poststreptococcal glomerulonephritis
  • Pulmonary edema
  • Respiratory distress

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

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