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 (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

Pulmonary Edema
Glomerulonephritis
Urinalysis
Hematuria
Thorax
Antistreptolysin
Blood Pressure
Hypertension
Complement C3
Delayed Diagnosis
Diuresis
Pleural Effusion
Secondary Prevention
Serum
Respiratory Insufficiency
Dyspnea
Antihypertensive Agents
Edema
Pneumonia
Respiration

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

引用此文

Poststreptococcal glomerulonephritis with pulmonary edema presenting as respiratory distress. / Chiu, Chih Yung; Huang, Yhu Chering; Wong, Kin Sun; Hsia, Shao Hsuan; Lin, Chi Jen; Lin, Tzou Yien.

於: Pediatric Nephrology, 卷 19, 編號 11, 11.2004, p. 1237-1240.

研究成果: 雜誌貢獻文章

Chiu, Chih Yung ; Huang, Yhu Chering ; Wong, Kin Sun ; Hsia, Shao Hsuan ; Lin, Chi Jen ; Lin, Tzou Yien. / Poststreptococcal glomerulonephritis with pulmonary edema presenting as respiratory distress. 於: Pediatric Nephrology. 2004 ; 卷 19, 編號 11. 頁 1237-1240.
@article{e85fb38a2c2945f1a4dc941341fd840e,
title = "Poststreptococcal glomerulonephritis with pulmonary edema presenting as respiratory distress",
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.",
keywords = "Poststreptococcal glomerulonephritis, Pulmonary edema, Respiratory distress",
author = "Chiu, {Chih Yung} and Huang, {Yhu Chering} and Wong, {Kin Sun} and Hsia, {Shao Hsuan} and Lin, {Chi Jen} and Lin, {Tzou Yien}",
year = "2004",
month = "11",
doi = "10.1007/s00467-004-1589-7",
language = "English",
volume = "19",
pages = "1237--1240",
journal = "Pediatric Nephrology",
issn = "0931-041X",
publisher = "Springer Verlag",
number = "11",

}

TY - JOUR

T1 - Poststreptococcal glomerulonephritis with pulmonary edema presenting as respiratory distress

AU - Chiu, Chih Yung

AU - Huang, Yhu Chering

AU - Wong, Kin Sun

AU - Hsia, Shao Hsuan

AU - Lin, Chi Jen

AU - Lin, Tzou Yien

PY - 2004/11

Y1 - 2004/11

N2 - 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.

AB - 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.

KW - Poststreptococcal glomerulonephritis

KW - Pulmonary edema

KW - Respiratory distress

UR - http://www.scopus.com/inward/record.url?scp=7744239843&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=7744239843&partnerID=8YFLogxK

U2 - 10.1007/s00467-004-1589-7

DO - 10.1007/s00467-004-1589-7

M3 - Article

C2 - 15449169

AN - SCOPUS:7744239843

VL - 19

SP - 1237

EP - 1240

JO - Pediatric Nephrology

JF - Pediatric Nephrology

SN - 0931-041X

IS - 11

ER -