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Post-streptococcal and Epidemic Glomerulonephritis

  • Ana Kleyce Correia Rocha
  • Artur Quintiliano Bezerra da Silva
  • Gianna Mastroianni Kirsztajn
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  • 27 Downloads

Abstract

Post-streptococcal GN (PSGN) is an immunologically mediated glomerulopathy, triggered by a previous streptococcal infection, with nephrogenic strains of group A beta-hemolytic streptococcus (GAS). The latency time between the infection and development of glomerulonephritis would be the necessary period for streptococcal antigens to induce antibody synthesis, followed by the formation and deposition of soluble immune complexes, with complement activation and consumption. Two antigens are currently actively investigated as potential causes of PSGN: nephritis-associated plasmin receptor (NAPlr) and a cationic cysteine known as streptococcal pyrogenic exotoxin B (SPEB). There is no specific treatment for acute diffuse glomerulonephritis. The treatment is basically supportive, being directed to the treatment of clinical manifestations, such as arterial hypertension control with loop diuretics (most commonly furosemide) at doses according to the edema, diuresis and degree of kidney failure, restriction of sodium and fluids, or calcium channel blockers, vasodilators, angiotensin-aldosterone system blockers, and angiotensin-receptor blockers, taking into consideration the risk of hyperkalemia with these last two medications.

Keywords

Bacterial infections Glomerulonephritis Streptococcus Membranoproliferative glomerulonephritis 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Ana Kleyce Correia Rocha
    • 1
  • Artur Quintiliano Bezerra da Silva
    • 1
  • Gianna Mastroianni Kirsztajn
    • 2
  1. 1.School of MedicineFederal University of Rio Grande do NorteNatalBrazil
  2. 2.Department of Medicine (Nephrology)Federal University of Sao PauloSao PauloBrazil

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