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

研究成果: 雜誌貢獻文章

10 引文 斯高帕斯(Scopus)

摘要

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.
原文英語
頁(從 - 到)1237-1240
頁數4
期刊Pediatric Nephrology
19
發行號11
DOIs
出版狀態已發佈 - 十一月 2004
對外發佈Yes

    指紋

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

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