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Post-enfeksiyöz glomerülonefrit sıklığı: tek merkez bulguları

Yıl 2018, Cilt: 43 Sayı: Ek 1, 194 - 198, 29.12.2018
https://doi.org/10.17826/cumj.441742

Öz

Amaç: Bu çalışmanın amacı Çukurova Üniversitesi Tıp Fakültesi Çocuk Nefroloji Bilim Dalında Kasım-Aralık 2016 aylarında başvuran hastalarda post-enfeksiyöz glomerülonefrit (PIGN) tanı sıklığını geriye dönük değerlendirmektir..

Gereç ve Yöntem: Bu tarihlerde kliniğimize başvuran 13 PIGN’li çocuk hastanın klinik, laboratuvar sonuçları ve takiplerinin sonuçları incelenmiştir.

Bulgular: Çalışamaya alınan 13 PIGN tanılı çocuğun ortalama yaşı 9 (3-15) idi. Tüm hastaların üst solunum yolu veya gastrointestinal enfeksiyon öyküsü vardı. Başvuru şikayetleri sıklık sırasına göre ödem (%70), oligüri (%38,5),  makroskobik hematüri (%23), hipertansiyon (%15,3), nefes darlığı (%15,3) idi. Kompleman C3 tüm hastalarda düşük iken bir hastada C3 ve C4 düşüklüğü vardı. Aynı hastada nefrotik düzeyde proteinüri ile birlikte akut böbrek yetmezliği vardı. Bu hastaya böbrek biyopsisi yapılarak diffüz proliferatif glomerülonefrit tanısı konuldu.

Sonuç: Günümüzde PIGN gelişmekte olan ülkelerde daha yüksek oranda görülmektedir. Biz de kısa bir dönem içerisinde PIGN hasta sayısında artış tespit ettik ve bu çalışma ile farklı klinik başlangıcı ve seyri olan bu hastalar için genel pediatri hekimlerinin dikkatini çekmeyi amaçladık.


Kaynakça

  • Rodríguez-Iturbe B, Najafian B, Silva A, Alpers CE. Acute Postinfectious Glomerulonephritis in Children.. In Pediatric Nephrology 7th edition Springer (Eds Avner ED, Harmon VE, Niaudet P, Yoshikawa N, Emma F, Goldstein SL): 959-981. Berlin Heidelberg, Verlag, 2016.
  • VanDeVoorde RG 3rd. Acute poststreptococcal glomerulonephritis: the most common acute glomerulonephritis. Pediatr Rev. 2015;36(1):3-12.
  • Aviles DH, Vehaskari VM. Acute Glomerulonephritis. In Clinical Pediatric Nephrology 3th edition. (Eds Kher KK, Schnaper HW, Greenbaum LA):401-417.Boca Raton, CRC Press Taylor&Francis group, 2017.
  • National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004;114:555–76.
  • Schwartz GJ, Munoz A, Schneider MF, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol 2009;20:629-37.
  • Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortin PR, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 2012;64(8):2677-86.
  • Eison TM, Ault BH, Jones DP, Chesney RW, Wyatt RJ. Post-streptococcal acute glomerulonephritis in children: clinical features and pathogenesis. Pediatr Nephrol 2011;26:165–80.
  • Dagan R, Cleper R, Davidovits M, Sinai-Trieman L, Krause I. Post-Infectious Glomerulonephritis in Pediatric Patients over Two Decades: Severity-Associated Features. Isr Med Assoc J 2016;18(6):336-40.
  • Bingler MA, Ellis D, Moritz ML. Acute post-streptococcal glomerulonephritis in a 14-month-old boy: why is this uncommon? Pediatr Nephrol 2007;22:448-50.
  • Demircioglu Kılıc B, Akbalık Kara M, Buyukcelik M, Balat A. Pediatric post-streptococcal glomerulonephritis: Clinical and laboratory data. Pediatr Int. 2018 May 5. doi: 10.1111/ped.13587. [Epub ahead of print]
  • Wong W, Lennon DR, Crone S, Neutze JM, Reed PW. Prospective population-based study on the burden of disease from post-streptococcal glomerulonephritis of hospitalized children in New Zealand: Epidemiology, clinical features, and complications. J Paediatr Child Health 2013;49:850–5.
  • Becquet O, Pasche J, Gatti H et al. Acute post-streptococcal glomerulonephritis in children of French Polynesia: a 3-year retrospective study. Pediatr Nephrol 2010;25: 275–80.
  • Wong W, Morris MC, Zwi J. Outcome of severe acute post-streptococcal glomerulonephritis in New Zealand children. Pediatr Nephrol 2009;24:1021–6.
  • Rodriguez-Iturbe B, Musser JM. The current state of poststreptococcal glomerulonephritis. J Am Soc Nephrol. 2008;19:1855–64.

Incidence of post-infectious glomerulonephritis: single center results

Yıl 2018, Cilt: 43 Sayı: Ek 1, 194 - 198, 29.12.2018
https://doi.org/10.17826/cumj.441742

Öz

Purpose: The aim of this study was to retrospectively evaluate the incidence of post-infectious glomerulonephritis (PIGN) in department of Pediatric Nephrology at Cukurova University  between November-December 2016. 

Materials and Methods: The clinical and laboratory datas of 13 children with PIGN who were seen in our clinic between November-December 2016, and their follow-up results were evaluated retrospectively.

Results: Thirteen children who diagnosed PIGN were evaluated with the mean age of 9 (3-15) years. All of the patients had history of throat or gastrointestinal infections. Symptoms of the patients at admission were edema (100%), oliguria (38.5%), macroscopic hematuria (23%), hypertension (15.3%), dispnea (15.3%), respectively. Serum complement C3 was low in all patients while one patient had both low serum complement C3 and C4. The patient who had hypocomplementemia (both C3 and C4) also had severe proteinuria and acute kidney injury. Renal biopsy was performed to this patient and diagnosed diffuse proliferative glomerulonephritis after renal biopsy.

Conclusion: PIGN is observed with higher incidence in the developing countries in current era.  We detected an increase in the number of PIGN patients in a short period and we aimed to draw attention of pediatricians about PIGN patients with different clinical presentations.


Kaynakça

  • Rodríguez-Iturbe B, Najafian B, Silva A, Alpers CE. Acute Postinfectious Glomerulonephritis in Children.. In Pediatric Nephrology 7th edition Springer (Eds Avner ED, Harmon VE, Niaudet P, Yoshikawa N, Emma F, Goldstein SL): 959-981. Berlin Heidelberg, Verlag, 2016.
  • VanDeVoorde RG 3rd. Acute poststreptococcal glomerulonephritis: the most common acute glomerulonephritis. Pediatr Rev. 2015;36(1):3-12.
  • Aviles DH, Vehaskari VM. Acute Glomerulonephritis. In Clinical Pediatric Nephrology 3th edition. (Eds Kher KK, Schnaper HW, Greenbaum LA):401-417.Boca Raton, CRC Press Taylor&Francis group, 2017.
  • National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004;114:555–76.
  • Schwartz GJ, Munoz A, Schneider MF, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol 2009;20:629-37.
  • Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortin PR, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 2012;64(8):2677-86.
  • Eison TM, Ault BH, Jones DP, Chesney RW, Wyatt RJ. Post-streptococcal acute glomerulonephritis in children: clinical features and pathogenesis. Pediatr Nephrol 2011;26:165–80.
  • Dagan R, Cleper R, Davidovits M, Sinai-Trieman L, Krause I. Post-Infectious Glomerulonephritis in Pediatric Patients over Two Decades: Severity-Associated Features. Isr Med Assoc J 2016;18(6):336-40.
  • Bingler MA, Ellis D, Moritz ML. Acute post-streptococcal glomerulonephritis in a 14-month-old boy: why is this uncommon? Pediatr Nephrol 2007;22:448-50.
  • Demircioglu Kılıc B, Akbalık Kara M, Buyukcelik M, Balat A. Pediatric post-streptococcal glomerulonephritis: Clinical and laboratory data. Pediatr Int. 2018 May 5. doi: 10.1111/ped.13587. [Epub ahead of print]
  • Wong W, Lennon DR, Crone S, Neutze JM, Reed PW. Prospective population-based study on the burden of disease from post-streptococcal glomerulonephritis of hospitalized children in New Zealand: Epidemiology, clinical features, and complications. J Paediatr Child Health 2013;49:850–5.
  • Becquet O, Pasche J, Gatti H et al. Acute post-streptococcal glomerulonephritis in children of French Polynesia: a 3-year retrospective study. Pediatr Nephrol 2010;25: 275–80.
  • Wong W, Morris MC, Zwi J. Outcome of severe acute post-streptococcal glomerulonephritis in New Zealand children. Pediatr Nephrol 2009;24:1021–6.
  • Rodriguez-Iturbe B, Musser JM. The current state of poststreptococcal glomerulonephritis. J Am Soc Nephrol. 2008;19:1855–64.
Toplam 14 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma
Yazarlar

Bahriye Atmış 0000-0002-1133-4845

Aysun Karabay Bayazıt 0000-0002-2644-5628

Engin Melek Bu kişi benim 0000-0003-4629-537X

Çağla Çağlı Bu kişi benim 0000-0002-0912-3045

Ali Anarat Bu kişi benim 0000-0001-8000-9213

Yayımlanma Tarihi 29 Aralık 2018
Kabul Tarihi 25 Temmuz 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 43 Sayı: Ek 1

Kaynak Göster

MLA Atmış, Bahriye vd. “Incidence of Post-Infectious Glomerulonephritis: Single Center Results”. Cukurova Medical Journal, c. 43, sy. Ek 1, 2018, ss. 194-8, doi:10.17826/cumj.441742.