Rapidly progressive glomerulonephritis in adolescents – aetiology and treatment based on case reports

• Main Authors: Beata Banaszak, Aurelia Morawiec-Knysak, Piotr Adamczyk, Maria Szczepańska
• Format: Article
• Language: English
• Published: Medical Communications Sp. z o.o. 2017-06-01
• Series: Pediatria i Medycyna Rodzinna
• Subjects: rapidly progressive glomerulonephritis; renal limited vasculitis; acute glomerulonephritis; adolescents
• Online Access: http://www.pimr.pl/index.php/issues/2017-vol-13-no-2/rapidly-progressive-glomerulonephritis-in-adolescents-aetiology-and-treatment-based-on-case-reports?aid=1074

Rapidly progressive glomerulonephritis is a disease characterised by an abrupt drop in glomerular filtration rate in a short period of time, which is caused by crescent formation seen in at least 50% of glomeruli. Two cases presented below illustrate rapid progressive glomerulonephritis in adolescents as a disease of heterogeneous aetiology that can develop both in the course of primary glomerulopathies and glomerulopathies secondary to systemic vasculitis. In the first case of an 11-year-old girl, nephritic syndrome with renal failure was accompanied by the presence of anti-myeloperoxidase antibodies in the serum, which in combination with the histopathological picture of the kidneys indicating pauci-immune rapidly progressive glomerulonephritis was the basis for the diagnosis of renal limited vasculitis. In the second case of a 16-year-old boy, an adverse course of acute post-streptococcal glomerulonephritis with features of severe and persistent glomerular filtration impairment was an indication for the verification of the diagnosis and identification of rapidly progressive glomerulonephritis based on a biopsy examination. Prompt diagnosis and inclusion of combined immunosuppressive therapy provided the chance to preserve renal function.