Pediatrik Akut Poststreptokokkal Glomerülonefritin Pandemi Öncesi ve Sonrası Dönemde Değişen Yüzü: Bir Karşılaştırma Çalışması

Yıl 2024, ERKEN GÖRÜNÜMLÜ MAKALELER, 1 - 7

Bahriye Uzun Kenan , Evrim Kargın Çakıcı , Tülin Güngör , Deniz Karakaya , Evra Çelikkaya , Aysun Çaltık Yılmaz

https://doi.org/10.12956/tchd.1494473

Öz

Amaç: Akut poststreptokokal glomerülonefrit (APSGN), çocuklarda akut glomerülonefritin önde gelen nedenidir. APSGN sıklıkla farenjit sonrasında, immün kompleks aracılı bir mekanizma ile streptokok antijenlerine karşı antikorların ve kompleman proteinlerinin aktivasyonuna bağlı olarak gelişir.

Gereç ve Yöntemler: Çalışmaya Eylül 2022 ile Mart 2023 tarihleri arasında APSGN tanısı konulan 18 yaş altı toplam 28 hasta dahil edildi ve bunlar, pandemi öncesi APSGN’li toplam 153 hastayla karşılaştırıldı.

Bulgular: Grup I’de (2010-2022) tanıda ortalama yaş 7.36±2.92 yıl, grup II’de ise 8.69±2.51 yıldı. Her iki çalışmada da hastaların dörtte üçünden fazlası [grup I/grup II; 106 (%69.3) / 21 (%71.4)] erkekti. Grup I’de en sık görülen bulgu hematüri iken, grup II’de en sık görülen bulgu hipertansiyondu. Kompleman 3 (C3) seviyeleri grup I’de önemli ölçüde daha düşüktü ve C3 iyileşme süresi grup II’de önemli ölçüde daha kısaydı. Grup I’deki hastaların yaklaşık yüzde yirmisi (%19.4) ve grup II’deki hastaların yalnızca biri hızla ilerleyen glomerülonefrite (RPGN) progrese oldu.

Sonuç: COVİD-19 salgını sonrası maske kullanımının terk edilmesiyle APSGN görülme sıklığı hızla arttı. Hastalar daha gürültülü bir klinikle prezente olsa da prognozları daha iyiydi.

Anahtar Kelimeler

Akut, Çocuk, COVİD-19 Pandemi, Poststreptokok Glomerülonefrit

Proje Numarası

bahriye-uzun-kenan-718088

Changing Face of Pediatric Acute Poststreptococcal Glomerulonephritis in the Pre and Post Pandemic Period: A Comparison Study

Öz

Objective: Acute poststreptococcal glomerulonephritis (APSGN) is the leading cause of acute glomerulonephritis in children. APSGN often develops after pharyngitis due to the activation of antibodies and complement proteins to streptococcal antigens by an immune complex-mediated mechanism. In this study, we aimed to analyze APSGN patients diagnosed before and after the pandemic, with their demographic characteristics , clinical and laboratory findings.

Material and Methods: In this study, patients diagnosed with APSGN in a tertiary children’s hospital between October 2022 and March 2023 were retrospectively analyzed. The patients were compared with a large cohort followed up with the same diagnosis between 2010-2022. The patients were divided into two groups: group I (n=153, pre-pandemic) and group II (n=28, post-pandemic). Clinical, radiologic, and laboratory findings were compared between the two groups.

Results: The mean age at diagnosis in the group I (2010-2022) was 7.36±2.92 years, and in the group II 8.69±2.51 years. More than three-fourths of the cases [group I/group II; 106 (69.3%) / 21 (71.4%)] were male in both studies. As macroscopic hematuria was the most common finding in the group I, hypertension was the most common finding in group II. Complement 3 (C3) levels were significantly lower in the group I and C3 recovery time was significantly shorter in the group II. Five (19.4%) of patients in group I and only one patient in group II progressed to RPGN.

Conclusion: The incidence of APSGN increased rapidly after the Covid-19 pandemic when the use of face masks was discontinued. Although the patients presented with a serious clinic, their prognosis was better.

Anahtar Kelimeler

Acute, Child, Covid-19, Pandemic, Poststreptecoccal glomerulonephritis

Etik Beyan

WE HAVE NO CONFLİCT OF İNTEREST TO DİSCLOSE.

Destekleyen Kurum

ANKARA ETLİK CİTY HOSPİTAL,ANKARA,TURKEY

Proje Numarası

bahriye-uzun-kenan-718088

Kaynakça

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