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Query: UMLS:C0018801 (heart failure)
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Acute poststreptococcal glomerulonephritis (PSGN) is the most common type of glomerulonephritis seen in children. It can affect multiple organs with heart being frequently involved. Yet, there are very few studies on cardiac status in children with PSGN and hence this study was conducted. All consecutive children from 1 month to 12 years of age, admitted over a two-year period with a diagnosis of PSGN, were included in the study. An electrocardiogram (ECG) and two-dimensional echocardiogram were performed in all patients on admission and repeated at six and 12 weeks, if abnormal. A total of thirty patients (18 males and 12 females) were enrolled in the study. The median age was six years. Prolonged QTc interval was found in 11 patients (37 %), of whom nine had hypertension. Seven of the 30 patients had a left ventricular ejection fraction (LVEF) <60%. The same patients also had left atrium/aorta ratio >2 and E/A ratio >2. LVEF returned to normal by six weeks in all except one patient, in whom it was normal by 12 weeks. Two of seven patients with low LVEF had normal blood pressure. All the seven patients recovered completely on follow-up. ECG and echocardiographic abnormalities may be seen in the acute phase of PSGN but are usually transient, returning to normal in most patients by three months. Although hypertension is the most common cause of cardiac failure, the role of primary myocardial dysfunction should also be considered.
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PMID:Cardiac status in children with acute poststreptococcal glomerulonephritis. 2874 85

Acute post-streptococcal glomerulonephritis (APSGN) is the commonest cause of acute glomerulonephritis (AGN), which usually present with gross hematuria, mild edema, oliguria, hypertension and varying degree of renal insufficiency. It is more common among the population of school going age where poverty, overcrowding and poor hygienic conditions are prevailing. This cross sectional observational study was aimed to know the socio-demographic variables, clinical profile and immediate outcome of AGN in hospitalized children and was conducted in the Pediatric department of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from November 2014 to April 2015. A detailed history was taken from the parents in each case with a written questionnaire. A written consent was also taken from the guardian of the including patients and also permission was taken from the ethical committee of MMCH. Thorough clinical examination and available relevant investigations were done in all patients. Progresses of the patient were monitored by daily clinical examinations and also by investigations. Data were analyzed by statistical package for social science (SPSS) windows version 18. Results were verified by doing standard test for significance. Among total 60 cases male was 58.3% & female was 41.7%. The common age group of presentation was between 7-12 years (73%), peak age of incidence was 7-9 years. Most of them came from low socioeconomic status (83.3%), 63.3% from rural area with average 5-6 member's family size. Most of the parents were illiterate. History of (H/O) skin infection was present in 35(58.3%) patients, 15(25%) had H/O sore throat, 15% did not give any H/O infection before presentation. Average duration of gap between infection and appearance of clinical feature was 7-14 days in 73.40%and 15-21 days was in 45.7% in case of sore throat & skin infection respectively. Almost all (95%) patients presented with puffiness of face, others presented with scanty micturition, gross hematuria, respiratory distress, fever, convulsion and altered sensorium. Edema (75%), hypertension (88.3%), pallor (38%), tachypnea (25%), tachycardia (26.7%) were the important clinical findings. Microscopic hematuria was present among 96.66% patients; low complement level was found in 85% cases. There is significant association between low socioeconomic statuses with more hospital stay. Only one patient died due to heart failure and 98.3% patient had complete recovery. Results of this study conclude that most of the patients came from rural illiterate family with low socioeconomic background. Skin infection is the commonest cause of acute glomerulonephritis. Edema, scanty micturation, hematuria and hypertension are the common mode of presentation. Heart failure and hypertensive encephalopathy are the common complication of AGN. Immediate prognosis of AGN was excellent.
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PMID:Clinical Profile and Immediate Outcome of Children Admitted With Acute Glomerulonephritis in Pediatrics Department of A Tertiary Level Hospital. 3191 29