A Case of Poststreptococcal Glomerulonephritis Representing Rapidly Progressive Glomerulonephritis in an Elderly Patient / 대한신장학회잡지

ABSTRACT

Postinfectious streptococcal glomerulonephritis (PSGN) presenting as a rapidly progressive glomerulonephritis (RPGN) and nephrotic syndrome (NS) is a rare disease in elderly patients. Here we report a case of PSGN with RPGN and NS in an elderly male patient with a complete recovery from his illness. A 73-year-old man was admitted for dyspnea, oliguria and generalized edema appearing after acute upper respiratory infection. On admission, he presented nephrotic range of proteinuria, decreased renal function with elevated ASO, and decreased C3 and CH50 concentrations. The renal biopsy showed marked cellular crescents in the glomeruli with collapsed glomerular tufts and inflammatory cell infiltration. There were prominent and various sizes of "humps" in subepithelial areas in electron microscopy. Under the diagnosis of PSGN with RPGN, we successfully treated the patient with steroid pulse therapy and hemodialysis. We would suggest that early diagnosis and aggressive steroid therapy should be indicated in the treatment of PSGN with RPGN.