A Clinical Profile and Immediate Outcome of Acute Glomerulonephritis (AGN) in Hospitalized Children

Abstract

Introduction: Acute glomerulonephritis includes renal diseases in which immunologic mechanism triggers inflammation and proliferation of glomerular tissue that can result in damage to the basement membrane, proliferation of mesangium, capillary endothelium. Objectives: The objective of this study is to know the clinical profile and immediate outcome of acute glomerulonephritis in hospitalized children. Material & Methods: The study was done in Chittagong Medical College Hospital Pediatric Unit during the period of June 2007 to February 2008. All patients admitted with AGN, with or without complications were included in this study. Diagnostic criteria were scanty urine (infrequent and less than normal in amount as stated by the parents), swelling, high colored urine with or without albuminuria, no past history of similar attack and microscopic or naked eye haematuria. Criteria of discharge from the hospital were absence of puffiness and oedema, adequate urine formation, absence of heart failure and hypertensive encephalopathy. These were taken as clinical recovery. No long-term follow up was done. Results: Seventy-eight cases of acute glomerulonephritis (AGN) in children under 12 years of age were studied. Male to female ration 3:2. Scanty urine (84.0%), puffy face (88.5%) h, haematuria (80.0%), hypertension (82.5%), heart failure (11.5%) convulsion (14%) anuria (3.8%), RBC (92.3%), RBC cast (41%), albumin one (+) (52.6%) two + (14.1%) three + (14.1%), raised s. creatinine was (25.6%), blood urea (26.9%). Four patients were died. Among them three was due to hypertension and heart failure. One due to the development of acute renal failure. History of skin infection like scabies was present in 61.4% patient. Conclusion: Skin infection is the commonest cause of acute glomerulonephritis. Nephritic presentation (scanty urine oedema, haematuria, hypertension and heart failure) was the commonest mode of presentation. Immediate prognosis was excellent- Long term follow up is recommended.