A Case of Acute Poststreptococcal Glomerulonephritis Accompanied with Acute Pyelonephritis

ABSTRACT

Acute poststreptococcal glomerulonephritis(APSGN) is the most common form of postinfectious glomerulonephritis, and acute pyelonephritis(APN) is the most severe form of urinary tract infection in childhood. However, the concurrence of two diseases is uncommon in the literature. We describe a case of APSGN accompanied with APN in a 5-year-old female who presented with fever, left flank pain, headache and facial edema. Urinalysis showed pyuria, microscopic hematuria, and mild proteinuira. Serial urine cultures grew Escherichia coli. (99m)Tc-DMSA renal scan revealed a cortical defect in the upper pole of left kidney. She had a history of preceding pharyngitis, in addition, showed high blood pressure, high anti-streptolysin O titer, and low serum complement levels. The patient improved completely with supportive treatment, including antibiotic and antihypertensive therapy. These findings suggested that APSGN and APN could be manifested simultaneously or be superimposed on each other.