Most Common Cause Of Nephritic Syndrome In A 4 Year Old Child

What is the most common cause of nephritic syndrome in a 4-year-old?
A) Trauma
B) Recent strep infection
C) Dehydration
D) Nonsteroidal anti-inflammatory drugs (NSAIDs)
E) Varicella infection

Answer and Discussion

The answer is B.Recent strep infection

Poststreptococcal glomerulonephritis is the leading cause of acute nephritic syndrome. The condition is most frequently encountered in children between 2 and 6 years of age with a recent history of pharyngitis. It is rare in children younger than 2 and adults older than 40.
The incidence of poststreptococcal glomerulonephritis appears to be decreasing.
The condition typically develops approximately 10 days after pharyngitis or 2 weeks after a skin infection with a nephritogenic strain of group A hemolytic Streptococcus. It has not been determined whether antibiotic treatment of the primary skin infection affords protection from the development of poststreptococcal glomerulonephritis.
The classic presentation of poststreptococcal glomerulonephritis is a nephritic syndrome with oliguric acute renal failure. Most patients have milder disease, and subclinical cases are common. Patients with severe disease experience gross hematuria characterized by red or smoky urine, headache, and generalized symptoms such as anorexia, nausea, vomiting, and malaise. Inflammation of the renal capsule can lead to flank or back pain.
Physical examination may show hypervolemia, edema, or hypertension. Acute poststreptococcal glomerulonephritis is usually diagnosed on clinical and serologic grounds without the need for biopsy, especially in children with a typical history.
The overall prognosis in classic poststreptococcal acute proliferative glomerulonephritis is good. Most patients recover spontaneously and return to baseline renal function within 3 to 4 weeks with
no long-term complications.