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ALL / Nephrology

Post-streptococcal glomerulonephritis

Post-streptococcal glomerulonephritis

Post-streptococcal glomerulonephritis typically occurs 7-14 days following a group A beta-haemolytic Streptococcus infection (usually Streptococcus pyogenes). It is caused by immune complex (IgG, IgM and C3) deposition in the glomeruli. Young children are most commonly affected.

Features
  • general
    • headache
    • malaise
  • visible haematuria
  • proteinuria
    • this may result in oedema
  • hypertension
  • oliguria
  • bloods:
    • raised anti-streptolysin O titre are used to confirm the diagnosis of a recent streptococcal infection
    • low C3


IgA nephropathy and post-streptococcal glomerulonephritis are often confused as they both can cause renal disease following an URTI

Renal biopsy features
  • post-streptococcal glomerulonephritis causes acute, diffuse proliferative glomerulonephritis
  • endothelial proliferation with neutrophils
  • electron microscopy: subepithelial 'humps' caused by lumpy immune complex deposits
  • immunofluorescence: granular or 'starry sky' appearance

Carries a good prognosis

Proliferation of endothelium and mesangium with recruitment of neutrophils. Tubules are normal
Subepithelial humps on the outside of the basal membrane
Electron microscopy. Numerous neutrophils (blue arrows) and subepithelial humps(red arrows)
+PassMedicine Notes

Post-streptococcal glomerulonephritis typically occurs 7-14 days following a group A beta-haemolytic Streptococcus infection (usually Streptococcus pyogenes). It is caused by immune complex (IgG, IgM and C3) deposition in the glomeruli. Young children are most commonly affected.

Features
  • general
    • headache
    • malaise
  • visible haematuria
  • proteinuria
    • this may result in oedema
  • hypertension
  • oliguria
  • bloods:
    • raised anti-streptolysin O titre are used to confirm the diagnosis of a recent streptococcal infection
    • low C3
pdd901.png IgA nephropathy and post-streptococcal glomerulonephritis are often confused as they both can cause renal disease following an URTI Renal biopsy features
  • post-streptococcal glomerulonephritis causes acute, diffuse proliferative glomerulonephritis
  • endothelial proliferation with neutrophils
  • electron microscopy: subepithelial 'humps' caused by lumpy immune complex deposits
  • immunofluorescence: granular or 'starry sky' appearance

Carries a good prognosis



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