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A Clinical Study on Children with Acute Glomerulonephritis.

Journal of the Korean Pediatric Society 1983;26(1):48-56.
Published online January 31, 1983.
A Clinical Study on Children with Acute Glomerulonephritis.
Jeong Gwon Lee, Dong Jin Lee, Sang Bum Lee, Ja Hoon Koo
Department of Pediatrics, Kyungpook National University School of Medicine,Taegu,Korea
소아급성사구체신염에 대한 임상적 관찰
이정권, 이동진, 이상범, 구자훈
경북대학교 의과대학 소아과교실
A clinical observation has been made on 104 children with acute glomerulonephritis who were admitted to pediatric Dept, of Kyung-Pook University hospital during 4 1/2 year period, from August 1977 to December 1981. Male to female ratio was 1.5 : 1 and peak incidence was noticed on cold months from November to January when URI was most prevalent. Cases were evenly distributed between. 4 to 12 years of age and affected rate below 3 years of age was quite low(6.5%). URI was the most common preceding illness(66.3%), followed by scarlet fever(4.8%) and impetigo(4.8%). Edema and gross hematuria were observed each in about two third of total cases and hypertension with diastolic BP over 90 mmHg was seen in 50.9%. Chest X-ray with hypertensive patient showed increased pulmonary vascular marking in 86.8%. However those from normotensive patient showed less involvement in cardiopulmonary status; revealing increased pulmonary vascular marking in 66.7%, pulmonary edema in 27.5% and cardiomegaly in 33.3%. Laboratory data at the time of admission showed elevated ESR in 75^ and mild anemia in.51%. On urinalysis proteinuria was seen in 65.2% and almost all cases except one showed hematuria. However, RBC cast was seen only 20.2%. ASLO titer over 300 Todd unit was found in 54.4% and serum creatinine and BUN were increased in 43.3% and 36.5% respectively. Serum protein, was decreased in. 30.4%. Serum complement (C3) levels were checked in 83 cases. In 72 cases in whom C3 determination was done with in 2 weeks after onset of illness, it was reduced in almost all case except in 5 cases(6%). However in 3 cases checked after 7 weeks of onset of illness, C3 leveL showed normal value. As complications, acute renal failure and hypertensive encephalopathy were seen in 9 cases respectively, congestive heart failure in 3 cases, secondary nephrotic syndrome in 6 cases,hyponatremia in 16 cases and hyperkalemia in 12 cases. Recovery from acute phase occured within 1st week in 34.1% and about two third of cases were recovered within 2 weeks. In 8 cases (9.4%), acute phase was prolonged over 5 weeks and 2 cases among this group had intermittent gross hematuria over 1 year, and were subsequently proved to be proliferative glomerulonephritis by renal biopsy.
Key Words: Acute glomerulonephritis, C3 change in acute glomerulonephritis.

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