DIAGNOSTIC PROBLEMS IN A PATIENT WITH NEPHRITIC SYNDROME

Abstract

Acute nephritic syndrome is a collection of clinical symptoms due to a sudden decrease in glomerular filtration rate (GFR) accompanied by water and salt retention, positive erythrocytes, erythrocytes cast and albumin in urinalysis. Information about nephritic syndrome is important to know for accurate diagnose and treatment. A 13-year-old adolescent with nephritic syndrome has been reported with rapid progressive glomerulonephritis (RPGN). He has been treated with corticosteroid, antibiotic, immunosuppressant, antihypertensives, and diuretic followed by improvement of clinical condition and laboratory of the patient. Biopsy was done for definitive diagnosis. The biopsy results showed a picture of IgA nephropathy (IgAN) and resolving stage of acute poststreptococcal glomerulonephritis (APSGN). Acute poststreptococcal glomerulonephritis (APSGN) was suspected due to finding of apparent hematuria, swollen and acute renal failure after streptococcal infection. To support the diagnosis, evidence of laboratory streptococcal infections and low levels of C3 complement are needed. Whereas IgAN known by examining the IgA serum. Management of patients were including supportive and symptomatic therapy. Giving corticosteroids or cytotoxic agents is needed for RPGN therapy. The prognosis is generally good, with improvement more than 90% of cases. Long-term observation is needed to observe the possibility of the disease being chronic. In this case, the symptoms and results of the laboratory examination were in accordance with the results of the biopsy, namely IgAN and resolving APSGN. Immediate and proper management provides an improvement in general and laboratory conditions.