Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) in a two-year-old.

Streptococcal pharyngitis testing and treatment is not routinely recommended in children under the age of 3 because of the unlikely occurrence of infection and negligible risk of serious complications. However, streptococcal pharyngitis and its resulting complications are not uncommon in this age group and can have serious consequences. We report a case of Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections in a 2-year-old with streptococcal pharyngitis. Testing and treatment for streptococcal pharyngitis should be strongly considered when there is evidence of infection and/or an immune-mediated streptococcal complication to prevent and/or decrease the severity of short- and long-term complications.

Acute Post-streptococcal Glomerulonephritis in a Pediatric Population: A Five-Year Retrospective Study.

INTRODUCTION: Post-streptococcal glomerulonephritis is a kidney disease that occurs after infection with a certain strain of streptococcal bacteria. It has a high hospitalization rate, especially in developing countries. It is characterized by the sudden appearance of edema, hematuria, proteinuria, and hypertension. The objective of this retrospective descriptive study conducted at James L. Gordon Memorial Hospital in Olongapo, Zambales, Philippines, is to analyze the demographic distribution, clinical presentation, complication, and outcome of acute post-streptococcal glomerulonephritis (APSGN) in a pediatric population.  Methods: A retrospective descriptive study was done in patients (below 18 years of age) admitted with the diagnosis of post-streptococcal glomerulonephritis during a five-year period in the pediatric ward of a tertiary hospital in the Philippines. All patients underwent detailed clinical history and examination and were closely monitored during treatment. The course of disease progression was closely monitored and recorded. RESULTS: Seventy-seven children were treated for APSGN with a mean age of 7.8 years and with standard deviation of 3.85. Edema and gross hematuria were noted in 53 (68.8%) and 24 (31.1%) cases, respectively. Hypertension was present in 54 patients (70.1%). Among those 54 patients, 49 (63.6%) patients developed acute renal injury (based on normal creatinine for age), three cases (3.8%) had pleural effusion, and two patients (2.5%) developed hypertensive encephalopathy. All patients underwent KUB (kidneys, ureters, and bladder) ultrasound, among which 13 (16.88%) had diffuse parenchymal swelling which improved and eventually were discharged. Increased blood urea nitrogen (BUN) was noted in 60-65% of patients. Hypoalbuminemia and lower hemoglobin were also quite common. There was no mortality during treatment and hospital stay. CONCLUSIONS: APSGN remains one of the most common causes of glomerulonephritis in the region. Edema, hypertension, and hematuria were the most common presenting features. Early identification and comprehensive monitoring and management are required to prevent morbidity and mortality. The prognosis is generally good if early treatment is done.

An unusual etiology in an 8-year-old girl with chest pain and elevated troponin-I.

Acute post-streptococcal glomerulonephritis (APSGN) is the most common glomerulonephritis of childhood, and clinical presentation can vary widely. This case report presents an atypical manifestation of APSGN in an 8-year-old female patient with pleuritic chest pain and elevated troponin-I, despite lacking classical kidney symptoms. Imaging studies showed cardiomegaly and interstitial lung opacities. Further investigations revealed hematuria and proteinuria, and the diagnosis was confirmed through elevated antistreptolysin-O (ASO) titers and low complement 3 (C3) levels. The patient was successfully managed with fluid restriction, diuretics, and antihypertensives, resulting in the resolution of symptoms and normalization of laboratory values. This case highlights the significance of recognizing atypical manifestations of APSGN for ensuring prompt diagnosis and proper management in the pediatric population.

Distinguishing Acute Rheumatic Fever From Post-streptococcal Reactive Arthritis.

We report an initial episode of post-streptococcal reactive arthritis (PRSA) in a 61-year-old male with group A streptococcal (GAS) bacteremia. The disease is commonly reported in young children and young adults. Additionally, this patient exemplifies the nonlinear boundaries of acute rheumatic fever (ARF) and PRSA, bringing into question whether they are truly distinct disease entities. These two conditions oftentimes present in similar fashions, making it difficult for clinicians to determine a specific diagnosis. We highlight the importance of recognizing ARF versus PRSA as an incorrect diagnosis can lead to the development of harmful complications including rheumatic heart disease (RHD).

Post-streptococcal small-vessel vasculitis in a 16-month-old with associated intussusception and hypertension: Henoch Schönlein purpura?

Henoch Schönlein purpura (HSP), also known as IgA vasculitis, is a systemic small-vessel vasculitis typically occurring in children 3-15 years of age, with peak incidence at 4-6 years. It is characterized by a constellation of symptoms including palpable purpura, arthralgias or arthritis, abdominal pain including intussusception, and renal involvement. We report a patient with these clinical findings whose IgA immunofluorescence was negative but with a presumptive diagnosis of HSP at 16 months of age, significantly younger than the classic population. This condition rarely affects this age group, and we highlight the importance of considering vasculitis in children of all ages, as a failure to diagnose could lead to insufficient long-term monitoring, particularly regarding renal function.

A 6-year review of acute post-streptococcal glomerulonephritis at a public children's hospital in Cape Town, South Africa.

BACKGROUND: Acute post-streptococcal glomerulonephritis (APSGN) is the most common cause of acute nephritis in children globally and, in some cases, may be associated with progressive kidney injury and failure, cumulating in the need for long-term dialysis and/or kidney transplantation. METHODS: Our retrospective study describes the occurrence of APSGN among children (< 14 years) admitted to a tertiary children's hospital in Cape Town, South Africa, from January 2015 to December 2020. RESULTS: Of 161 children who presented with acute nephritis (haematuria, oedema, oliguria, and hypertension), 100 met the inclusion criteria. Demographic, clinical features, laboratory findings, management, and outcome data were collected. APSGN was defined by the clinical presentation of at least two clinical signs of acute nephritis, and low serum complement 3 (C3) level or evidence of a recent streptococcal infection. Most cases of APSGN were associated with streptococcal skin infections: 55/100 (55%); 10/100 (10%) children presented with hypertensive seizures; C3 levels were low in 86/92 (93.5%) children; 94/94 (100%) children had elevated anti-deoxyribonuclease-B (anti-DNase-B) levels; and 80/94 (85%) also had elevated anti-streptolysin O titre (ASOT) at presentation. Eleven (11%) children had a percutaneous kidney biopsy; 4/11 (36%) showed histological features of post-infectious nephritis, and 7/11(64%) also had crescentic glomerulonephritis with immune complex deposits. Sixty-two (62%) children confirmed recovered, and five (5%) progressed to kidney failure, but 29 presumed recovered as they did not return for follow-up to our institution. CONCLUSIONS: Childhood APSGN remains an important health problem in South Africa (SA) with favourable outcomes in most, apart from those with crescentic glomerulonephritis who progressed to kidney failure.

Angiotensin II and post-streptococcal glomerulonephritis.

BACKGROUND: Post-streptococcal glomerulonephritis (PSGN) is a consequence of the infection by group A beta-hemolytic streptococcus. During this infection, various immunological processes generated by streptococcal antigens are triggered, such as the induction of antibodies and immune complexes. This activation of the immune system involves both innate and acquired immunity. The immunological events that occur at the renal level lead to kidney damage with chronic renal failure as well as resolution of the pathological process (in most cases). Angiotensin II (Ang II) is a molecule with vasopressor and pro-inflammatory capacities, being an important factor in various inflammatory processes. During PSGN some events are defined that make Ang II conceivable as a molecule involved in the inflammatory processes during the disease. CONCLUSION: This review is focused on defining which reported events would be related to the presence of this hormone in PSGN.

State transitions across the Strep A disease spectrum: scoping review and evidence gaps.

The spectrum of diseases caused by Streptococcus pyogenes (Strep A) ranges from superficial to serious life-threatening invasive infections. We conducted a scoping review of published articles between 1980 and 2021 to synthesize evidence of state transitions across the Strep A disease spectrum. We identified 175 articles reporting 262 distinct observations of Strep A disease state transitions. Among the included articles, the transition from an invasive or toxin-mediated disease state to another disease state (i.e., to recurrent ARF, RHD or death) was described 115 times (43.9% of all included transition pairs) while the transition to and from locally invasive category was the lowest (n = 7; 0.02%). Transitions from well to any other state was most frequently reported (49%) whereas a relatively higher number of studies (n = 71) reported transition from invasive disease to death. Transitions from any disease state to locally invasive, Strep A pharyngitis to invasive disease, and chronic kidney disease to death were lacking. Transitions related to severe invasive diseases were more frequently reported than superficial ones. Most evidence originated from high-income countries and there is a critical need for new studies in low- and middle-income countries to infer the state transitions across the Strep A disease spectrum in these high-burden settings.

Anti-factor H antibody-positive C3 glomerulonephritis secondary to poststreptococcal acute glomerulonephritis with diabetic nephropathy.

Poststreptococcal acute kidney glomerulonephritis (PSAGN) has been seen in adults in recent years, especially in patients with type 2 diabetes mellitus, and the renal prognosis has not always been good. There have been cases of PSAGN in which complete remission was not achieved and hematuria and proteinuria persisted, leading to end-stage renal disease. Previous reports showed that the patients subjected to PSAGN have an underlying defect in regulating the alternative pathway of complement, and they identified that antibodies to the C3 convertase, C3 nephritic factors (C3NeF), are involved. C3NeF stabilizes C3 convertase, sustains C3 activation, and causes C3 glomerulonephritis (C3GN). On the other hand, factor H is a glycoprotein that suppresses the overactivation of the alternative pathway by decaying the C3 convertase. Anti-factor H (aFH) antibodies interfere with factor H and cause the same activation of the alternative pathway as C3NeF. However, a limited number of reports describe the clinical course of C3GN with aFH antibodies. We encountered a 49-year-old Japanese man with type 2 diabetes mellitus. He was referred to our hospital because of his elevated serum creatinine, proteinuria, hematuria, and developed edema on both legs. He was diagnosed as PSAGN at the first kidney biopsy, and his renal function improved and edema and hematuria disappeared, but proteinuria persisted after 5 months. He was diagnosed as C3GN at the second kidney biopsy. In our case, no C3NeF was detected. However, a high titer of aFH antibodies was detected in stored serum from the initial presentation, providing a unified diagnosis of aFH antibody-positive C3GN secondary to PSAGN. He progressed to end-stage renal disease (ESRD) and hemodialysis was started. The persistence of high levels of aFH autoantibodies may have caused C3GN secondary to PSAGN due to activating the alternative complement pathway, which eventually worsened the nephropathy and led to ESRD.

A novel case of acute glomerulonephritis with concurrent acute non-rheumatic myocarditis following group a streptococcal infection.

Streptococcal infection is a common cause of acute glomerulonephritis. Cardiac damage associated with streptococcal infection commonly occurs in acute rheumatic fever. However, cases of acute non-rheumatic streptococcal myocarditis have been reported in recent years. We report a novel case of concurrent acute glomerulonephritis and non-rheumatic myocarditis following streptococcal infection. A good prognosis was achieved with antibiotic and immunosuppressive therapy, indicating that Streptococcus causes cardiorenal syndrome type 5 via an immune-mediated response. A better understanding of post-streptococcal cardiorenal syndrome is warranted to enable the early diagnosis and treatment of affected patients.

Case report: A pediatric case of MPO-ANCA-associated granulomatosis with polyangiitis superimposed on post-streptococcal acute glomerulonephritis.

An eight-year-old girl was admitted with vomiting, gross hematuria, and progressive renal dysfunction. A renal biopsy revealed endocapillary proliferative glomerulopathy and crescent formation. Immunofluorescence staining revealed diffuse granular deposits of IgG and C3. Post-streptococcal acute glomerulonephritis (PSAGN) was suspected, based on the elevated anti-streptolysin O levels, decreased serum C3 concentrations, and histologic findings. The myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA) test was positive, and the young patient gradually developed palisaded neutrophilic and granulomatous dermatitis (PNGD), orbital and paranasal sinus granulomatous neoplasms, along with intermittent nose, head, and orbital pain. Finally, she was diagnosed with the rare MPO-ANCA-associated granulomatosis with polyangiitis (GPA) superimposed on PSAGN. The patient was treated with aggressive renal replacement therapy, methylprednisolone pulse therapy, and intravenous pulse cyclophosphamide; her renal function normalized, and her pain symptoms improved.

Pediatric Posterior Reversible Encephalopathy Syndrome Secondary to Post-Streptococcal Glomerulonephritis: A Case Report.

This case report presents a unique case of a 15-year-old male with post-streptococcal glomerulonephritis (PSGN) who developed posterior reversible encephalopathy syndrome (PRES). The patient presented with symptoms of fever, headache, emesis, visual disturbances, and involuntary movements of all four limbs. On examination, the patient had elevated blood pressure, decreased visual acuity of the left eye, leukocytosis, and uremia. MRI findings showed symmetrical enhancement of superficial and deep watershed areas, predominantly in the occipital and temporal regions. Treatment with antibiotics and anti-hypertensives resulted in the complete resolution of hyperintense lesions seen in brain MRI after three weeks, and the patient remained symptom-free for one month. This case highlights the rare association between PSGN and PRES and emphasizes the importance of monitoring and managing hypertension in patients with PSGN. Understanding the association between these two conditions may lead to earlier diagnosis and treatment of PRES, ultimately improving patient outcomes.

Clinical profile of children with acute post-streptococcal glomerulonephritis.

BACKGROUND: Acute post-streptococcal glomerulonephritis (APSGN) is common in developing countries with a high hospitalization rate. Most patients have acute nephritic syndrome features, although some occasionally present with unusual clinical features. This study aims to describe and analyze clinical features, complications, and laboratory parameters in children diagnosed with APSGN at presentation, 4 and 12 weeks later, in a resource-limited setting. METHODS: This cross-sectional study was conducted among children < 16 years with APSGN between January 2015 and July 2022. Hospital medical records and outpatient cards were reviewed for clinical findings, laboratory parameters, and kidney biopsy results. Descriptive analysis of multiple categorical variables was performed using SPSS version 16.0 and presented as frequencies and percentages. RESULTS: The study included 77 patients. Most (94.8%) were older than five years, and age group 5-12 years had highest prevalence (72.7%). Boys were affected more frequently than girls (66.2% vs. 33.8%). Edema (93.5%), hypertension (87%), and gross hematuria (67.5%) were the most frequent presenting symptoms, and pulmonary edema (23.4%) was the most common severe complication. Anti-DNase B and anti-streptolysin O titers were positive in 86.9% and 72.7%, respectively, and 96.1% had C3 hypocomplementemia. Most clinical features resolved in three months. However, at 3 months, 6.5% of patients had persistent hypertension, impaired kidney function, and proteinuria alone or in combination. Most patients (84.4%) had an uncomplicated course; 12 underwent kidney biopsy, 9 required corticosteroids, and 1 required kidney replacement therapy. There was no mortality during the study period. CONCLUSION: Generalized swelling, hypertension, and hematuria were most common presenting features. Persistent hypertension, impaired kidney function, and proteinuria persisted in a small proportion who had a significant clinical course and required kidney biopsy. A higher resolution version of the Graphical abstract is available as Supplementary information.

Predictors of rapidly progressive glomerulonephritis in acute poststreptococcal glomerulonephritis.

BACKGROUND: Acute post-streptococcal glomerulonephritis (APSGN) is an immune-mediated inflammatory respsonse in the kidneys caused by nephritogenic strains of group A ß-hemolytic streptococcus (GAS). The present study aimed to present a large patient cohort of APSGN patients to determine the factors that can be used for predicting the prognosis and progression to rapidly progressive glomerulonephritis (RPGN). METHODS: The study included 153 children with APSGN that were seen between January 2010 and January 2022. Inclusion criteria were age 1-18 years and follow-up of ≥ 1 years. Patients with a diagnosis that could not be clearly proven clinically or via biopsy and with prior clinical or histological evidence of underlying kidney disease or chronic kidney disease (CKD) were excluded from the study. RESULTS: Mean age was 7.36 ± 2.92 years, and 30.7% of the group was female. Among the 153 patients, 19 (12.4%) progressed to RPGN. The complement factor 3 and albumin levels were significantly low in the patients who had RPGN (P = 0.019). Inflammatory parameters, such as C-reactive protein (CRP), platelet-to-lymphocyte ratio, CRP/albumin ratio, and the erythrocyte sedimentation rate level at presentation were significantly higher in the patients with RPGN (P < 0.05). Additionally, there was a significant correlation between nephrotic range proteinuria and the course of RPGN (P = 0.024). CONCLUSIONS: We suggest the possibility that RPGN can be predicted in APSGN with clinical and laboratory findings. A higher resolution version of the Graphical abstract is available as Supplementary information.

A case of a pulmonary-renal syndrome caused by streptococcal infection.

Pulmonary-renal syndrome (PRS) is defined as a combination of diffuse alveolar haemorrhage and glomerulonephritis. An 18-year-old woman visited our hospital with a 2-day history of fever, dyspnoea, and leg edema. Laboratory investigations revealed an elevated inflammatory reaction, increased serum creatinine levels, and normocytic anaemia. Additionally, the anti-streptolysin-O titre was positive, and complement component-3 levels were decreased. Urinalysis revealed proteinuria and hematuria. Bronchoalveolar lavage aliquots were progressively more hemorrhagic. These findings supported a diagnosis of PRS secondary to streptococcal infection. The patient was treated with high-dose methylprednisolone and antibiotics. After 4 days of treatment, her respiratory symptoms and serum creatinine levels improved. Steroid tapering was performed over 15 days. The findings in this case indicate that streptococcal infection is a potential cause of PRS, and that short-term steroid therapy is an effective treatment.

Acute Uveitis in a Background of Streptococcal Sepsis: Infective or Inflammatory?

BACKGROUND: The pathophysiology of uveitis in a patient with post-streptococcal syndrome with evidence of bacterial sepsis may be difficult to classify as being infective or an inflammatory etiology. CASE REPORT: Our patient presented with uveitis with systemic features of reactive arthritis and acute renal failure in a background of sepsis with group A streptococcus. Treatment with topical steroids lead to the resolution of this type of uveitis. CONCLUSION: It is safe to consider uveitis as being inflammatory rather than infectious and treat appropriately, when evidence suggesting other features of post -streptococcal syndrome are present.

Infection-Related Glomerulonephritis in Children and Adults.

Infection-related glomerulonephritis is an immunologically mediated glomerular injury after an infection. Glomerulonephritis may occur with the infection or after a variable latent period. Poststreptococcal glomerulonephritis (PSGN) is the prototype of infection-related glomerulonephritis. The streptococcal antigens, nephritis-associated plasmin-like receptor and streptococcal exotoxin B, have emerged as major players in the pathogenesis of PSGN. Although PSGN is the most common infection-related glomerulonephritis in children, in adults, glomerulonephritis is secondary to bacteria such as staphylococci, viruses such as hepatitis C, and human immunodeficiency virus, and, rarely, parasitic infections. Supportive therapy is the mainstay of treatment in most infection-related glomerulonephritis. Treatment of the underlying infection with specific antibiotics and antiviral medications is indicated in some infections. Parasitic infections, although rare, may be associated with significant morbidity. Poststreptococcal glomerulonephritis is a self-limiting condition with a good prognosis. However, bacterial, viral, and parasitic infections may be associated with significant morbidity and long-term consequences. Epidemiologic studies are required to assess the global burden of infection-related glomerulonephritis. A better understanding of the pathogenesis of infection-related glomerulonephritis may unravel more treatment options and preventive strategies.

Niño de 5 años con macrohematuria ¿Sabríamos ante qué glomerulopatía estamos? / Five-year-old with macrohematuria... Would we know what glomerulopathy we’re dealing with?

Presentamos el caso de un escolar de 5 años que consulta en nuestro servicio por macrohematuria. Tras confirmarse el origen glomerular de la misma se sospecha glomerulonefritis aguda postestreptocócica debido al antecedente de infección faringoamigdalar, sin embargo el complemento es normal. Presenta deterioro rápido y progresivo de función renal, por lo que es diagnosticado de glomerulonefritis aguda rápidamente progresiva. Se realiza biopsia renal, donde se evidencia semilunas en un 81% de los glomérulos y depósitos de C3, compatible con glomerulonefritis aguda postinfecciosa. Inmediatamente después, se inicia tratamiento corticoideo presentando una evolución excelente y con recuperación completa de la función renal. Solo el 10-20% de la glomerulonefritis aguda postinfecciosas cursan con niveles de complemento normal, y solo el 0,5% de los casos se manifiesta como una glomerulonefritis rápidamente progresiva. La macrohematuria en niños puede suponer un reto diagnóstico. En ocasiones las manifestaciones son muy variable y superponibles a diferentes causa y hasta la biopsia no podemos llegar a un diagnóstico fiable.(AU)

We present the case of a 5-year-old school boy who consulted our department for asymptomatic macrohematuria. After confirming the glomerular origin, poststreptococcal acute glomerulonephritis was suspected due to a history of pharyngotonsillar infection, however the complement is normal. He presents rapid and progressive deterioration of kidney function, which is why he is diagnosed with rapidly progressive acute glomerulonephritis. A renal biopsy was performed, showing crescents in 81% of the glomeruli and C3 deposits, compatible with acute post-infectious glomerulonephritis. Immediately afterwards, corticosteroid treatment was started, with excellent progress and complete recovery of kidney function. Only 10-20% of acute post-infectious glomerulonephritis present with normal complement levels, and only 0.5% of cases manifest as rapidly progressive glomerulonephritis. Macrohematuria in children can be a diagnostic challenge. Sometimes the manifestations are very variable and can be attributed to different causes and until the biopsy we cannot reach a reliable diagnosis.(AU)

Complicaciones de glomerulonefritis aguda postestreptocócica en el servicio de nefrología del Hospital Infantil Doctor Robert Reid Cabral / Complications of acute poststreptococcal glomerulonephritis in the nephrology department of the Children's Hospital Dr. Robert Reid Cabral

Conflicto de intereses Inexistencia de conflicto de intereses Aspectos éticos El presente estudio fue ejecutado con apego a las normativas éticas internacionales, incluyendo los aspectos relevantes de la Declaración de Helsinki y del Consejo de Organizaciones Internacionales de las Ciencias Médicas (CIOMS) donde se observa que el propósito principal de la investigación médica en seres humanos es mejorar los procedimientos preventivos, diagnósticos y terapéuticos, y también comprender la etiología y patogenia de las enfermedades. Incluso, los mejores métodos preventivos, diagnósticos y terapéuticos disponibles deben ponerse a prueba continuamente a través de la investigación para que sean eficaces, efectivos, accesibles y de calidad.1 Tomando estas pautas el protocolo del presente estudio y los instrumentos diseñados para el mismo fueron sometidos a la revisión del Comité de Ética de la Universidad Nacional Pedro Henríquez Ureña, a través de la Escuela de Medicina y de la coordinación de la Unidad de Investigación de la Universidad, así como al comité de investigación del hospital infantil Dr. Robert Reid Cabral, cuya aprobación fue el requisito para el inicio del proceso de recopilación y verificación de datos. Por lo tanto, el estudio implicó el manejo de datos identificatorios, ofrecidos por el personal que labora en el centro de salud. Los mismos fueron analizados con suma cautela e introducidos en la base de datos creada de forma que toda información fuese protegida por una clave asignada únicamente por los investigadores para de esta manera mantener el estricto apego a la confidencialidad. Introducción. La glomerulonefritis aguda posestreptocócica (GNAPE), es una enfermedad frecuente en pediatría. Se presenta posterior a una infección causada por estreptococo betahemolítico del grupo A. Se caracteriza por la tríada de edema, hematuria e hipertensión. Objetivo: Determinar la frecuencia de complicaciones de glomerulonefritis aguda posestreptocócica en el hospital infantil Dr. Robert Reid Cabral, 2020-2021. Material y métodos: Para la obtención de los datos fue diseñado un formulario que contiene un total de 8 acápites donde se describen datos sociodemográficos como la edad, sexo, estación del año y datos relacionados con las complicaciones, antecedentes patológicos, comorbilidades, manifestaciones clínicas y función renal. Resultados: De los 426 expedientes clínicos de pacientes pediátricos, en estos se encontró que 19,2 por ciento presentaron complicaciones de glomerulonefritis aguda posestreptocócica. Conclusión: En la investigación, se pudo determinar que la crisis hipertensiva fue la complicación más frecuente con un 50,0 por ciento. El 46,3 por ciento de los pacientes tenían edad entre 10 y 14 años. El 57,3 por ciento eran masculino. El 28,0 por ciento de los casos tuvieron mayor prevalencia en otoño. La infección cutánea fue el antecedente patológico más frecuente con un 65,8 por ciento. El asma fue la comorbilidad más frecuente con un 42,3 por ciento. La hipertensión arterial fue la manifestación clínica más frecuente con un 93,9 por ciento. El 39,0 por ciento de los pacientes presentaron una función renal grado II.

Introduction. Acute poststreptococcal glomerulo-nephritis (PSGN) is a common disease in pediatrics. It presents after an infection caused by group A beta-he-molytic streptococcus. It is characterized by the triad of edema, hematuria, and hypertension.Objective: To determine the frequency of complica-tions of acute poststreptococcal glomerulonephritis at the hospital infantil Dr. Robert Reid Cabral, 2020-2021.Material and method. To obtain the data, a form was designed that contains a total of 8 sections where socio-demographic data such as age, sex, season of the year and data related to complications, pathological history, comorbidities, clinical manifestations and renal func-tion are described.Results. Of the 426 clinical records of pediatric pa-tients, it was found that 19.2 percent presented compli-cations of acute poststreptococcal glomerulonephritis.Conclusion. In the investigation, it was possible to de-termine that the hypertensive crisis was the most fre-quent complication with 50.0 percent. 46.3 percent of the patients are between 10 and 14 years old. 57.3 percent were male. 28.0 percent of the cases had hi-gher prevalence in autumn. Cutaneous infection was the most frequent pathological antecedent with 65.8 percent. Asthma was the most frequent comorbidity with 42.3 percent. Arterial hypertension was the most frequent clinical manifestation with 93.9 percent. 39.0 percent of the patients presented renal function grade II