Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Acute Poststreptococcal Glomerulonephritis Differential Diagnoses

  • Author: Rajendra Bhimma, MB, MD, ChB, PhD, DCH (SA), FCP(Paeds)(SA), MMed(Natal); Chief Editor: Craig B Langman, MD  more...
 
Updated: May 27, 2015
 
 

Diagnostic Considerations

In the evaluation of a patient with acute glomerulonephritis, if evidence of a previous streptococcal infection is missing or inconclusive, then a search for another infectious cause appears appropriate.

See also Acute Glomerulonephritis and Emergent Management of Acute Glomerulonephritis.

Bacterial and viral infections

The syndrome of acute glomerulonephritis has been reported following many other bacterial illnesses (eg, Streptococcus pneumoniae, Staphylococcus aureus and S epidermidis, Rickettsia rickettsiae, Mycoplasma species, Meningococcus species, Leptospira species). In addition, certain viral illnesses have preceded the onset of fairly typical acute glomerulonephritis; among the most common are varicella-zoster virus (VZV), cytomegalovirus (CMV), and the Epstein-Barr virus (EBV).

IgA-associated glomerulonephritis

Immunoglobulin A (IgA)–associated glomerulonephritis may be confused with acute poststreptococcal glomerulonephritis.[4, 18, 43, 55] In the form of IgA nephropathy associated with a typical anaphylactoid purpura (ie, Henoch-Schönlein purpura nephritis), the characteristic rash and the associated symptoms of either abdominal pain or arthritis and/or arthralgia help in the differentiation; however, in atypical cases, marked similarity may be present.

All of the clinical manifestations of APSGN have been reported in persons with Henoch-Schönlein purpura nephritis, although significant hypertension and edema are found less commonly in individuals with Henoch-Schönlein purpura than in those with APSGN. In addition, evidence of a previous streptococcal illness is usually lacking in individuals with Henoch-Schönlein purpura nephritis, and complement values (C3 and/or C4) are usually normal.

Urticarial or purpuric rashes, abdominal complaints, and arthritis and/or arthralgia are found almost exclusively in persons with Henoch-Schönlein purpura.

Berger disease or IgA nephropathy usually presents as an episode of gross hematuria occurring during the early stages of a respiratory illness; no latent period occurs, and hypertension or edema is uncommon.

Recurrent episodes of gross hematuria, associated with respiratory illnesses, followed by persistent microscopic hematuria, are highly suggestive of IgA nephropathy. In contrast, acute poststreptococcal glomerulonephritis usually does not recur, and second episodes are rare.

MPGN

Mesangiocapillary or membranoproliferative glomerulonephritis (MPGN) may have a presentation that is virtually identical to that of poststreptococcal acute glomerulonephritis. The initial manifestations are often more serious in persons with MPGN than in those with IgA nephropathy; the renal function is reduced markedly (ie, large elevation of serum creatinine).

Evidence of preexisting streptococcal infection is absent, although cases of MPGN have been reported in which clear evidence of such an infection is present. In most cases, C3 levels are depressed persistently, longer than 6 weeks.

Urinary abnormalities persist past the time of expected resolution for acute poststreptococcal glomerulonephritis.

Crescentic glomerulonephritis

Crescentic glomerulonephritis is the term used to describe a histologic picture of severe proliferative glomerulonephritis. In persons with crescentic glomerulonephritis, in addition to inflammatory changes within the glomerular tuft, extensive proliferation exists within the Bowman space, leading to the formation of synechiae between the glomerular tuft and Bowman capsule.[43]

The clinical picture is generally referred to as rapidly progressive glomerulonephritis and may be secondary to numerous causes, including an immune-complex mediated poststreptococcal nephritis. The initial clinical picture is generally severe, and resolution appears delayed.

Other types of glomerulonephritis

Other forms of glomerulonephritis (eg, systemic lupus erythematosus nephritis, familial nephritis, chronic glomerulonephritis) may occasionally be confused with acute poststreptococcal glomerulonephritis when an acute exacerbation of the previously present nephropathy is present. In addition to the lack of expected complete resolution, other features suggest a condition other than acute poststreptococcal glomerulonephritis.

See Hemolytic Complement under Workup for the differential diagnosis of acute glomerulonephritis according to C3 levels.

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Rajendra Bhimma, MB, MD, ChB, PhD, DCH (SA), FCP(Paeds)(SA), MMed(Natal) Associate Professor of Pediatrics, Principal Specialist, Department of Pediatrics and Child Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, South Africa

Rajendra Bhimma, MB, MD, ChB, PhD, DCH (SA), FCP(Paeds)(SA), MMed(Natal) is a member of the following medical societies: American Association for the Advancement of Science, International Society of Nephrology, South African Medical Association, South African Paediatric Association, South African Transplant Society, International Pediatric Transplant Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Adrian Spitzer, MD Clinical Professor Emeritus, Department of Pediatrics, Albert Einstein College of Medicine

Adrian Spitzer, MD is a member of the following medical societies: American Academy of Pediatrics, American Federation for Medical Research, American Pediatric Society, American Society of Nephrology, American Society of Pediatric Nephrology, International Society of Nephrology, Society for Pediatric Research

Disclosure: Nothing to disclose.

Chief Editor

Craig B Langman, MD The Isaac A Abt, MD, Professor of Kidney Diseases, Northwestern University, The Feinberg School of Medicine; Division Head of Kidney Diseases, The Ann and Robert H Lurie Children's Hospital of Chicago

Craig B Langman, MD is a member of the following medical societies: American Academy of Pediatrics, American Society of Nephrology, International Society of Nephrology

Disclosure: Received income in an amount equal to or greater than $250 from: Alexion Pharmaceuticals; Raptor Pharmaceuticals; Eli Lilly and Company; Dicerna<br/>Received grant/research funds from NIH for none; Received grant/research funds from Raptor Pharmaceuticals, Inc for none; Received grant/research funds from Alexion Pharmaceuticals, Inc. for none; Received consulting fee from DiCerna Pharmaceutical Inc. for none.

Additional Contributors

Richard Neiberger, MD, PhD Director of Pediatric Renal Stone Disease Clinic, Associate Professor, Department of Pediatrics, Division of Nephrology, University of Florida College of Medicine and Shands Hospital

Richard Neiberger, MD, PhD is a member of the following medical societies: American Academy of Pediatrics, American Federation for Medical Research, American Medical Association, American Society of Nephrology, American Society of Pediatric Nephrology, Christian Medical and Dental Associations, Florida Medical Association, International Society for Peritoneal Dialysis, International Society of Nephrology, National Kidney Foundation, New York Academy of Sciences, Shock Society, Sigma Xi, Southern Medical Association, Southern Society for Pediatric Research, Southwest Pediatric Nephrology Study Group

Disclosure: Nothing to disclose.

Acknowledgements

Yang Sun Kim MD, Assistant Professor, Department of Pediatrics, Division of Neonatology, New York University Medical Center; Clinical Director, Neonatology Intensive Care Unit, Bellevue Hospital

Disclosure: Nothing to disclose.

Robert G Schacht, MD, Professor, Vice-Chair of Pediatrics, Department of Pediatrics, Division of Nephrology, New York University Medical Center.

Disclosure: Nothing to disclose.

Luther Travis, MD Professor Emeritus, Departments of Pediatrics, Nephrology and Diabetes, University of Texas Medical Branch School of Medicine

Luther Travis, MD is a member of the following medical societies: Alpha Omega Alpha, American Federation for Medical Research, International Society of Nephrology, and Texas Pediatric Society

Disclosure: Nothing to disclose.

References
  1. Avner ED, Davis ID. Acute poststreptococcal glomerulonephritis. Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. 17th ed. Philadelphia, Pa: Elsevier Science; 2004. 1740-41.

  2. Rodríguez-Iturbe B, Batsford S. Pathogenesis of poststreptococcal glomerulonephritis a century after Clemens von Pirquet. Kidney Int. 2007 Jun. 71(11):1094-104. [Medline].

  3. Blyth CC, Robertson PW, Rosenberg AR. Post-streptococcal glomerulonephritis in Sydney: a 16-year retrospective review. J Paediatr Child Health. 2007 Jun. 43(6):446-50. [Medline].

  4. Sanjad S, Tolaymat A, Whitworth J, Levin S. Acute glomerulonephritis in children: a review of 153 cases. South Med J. 1977 Oct. 70(10):1202-6. [Medline].

  5. Sagel I, Treser G, Ty A, et al. Occurrence and nature of glomerular lesions after group A streptococci infections in children. Ann Intern Med. 1973 Oct. 79(4):492-9. [Medline].

  6. Kimmelstiel P. The hump-a lesion of glomerulonephritis. Bull Pathol. 1965. 6:187.

  7. Nissenson AR, Baraff LJ, Fine RN, Knutson DW. Poststreptococcal acute glomerulonephritis: fact and controversy. Ann Intern Med. 1979 Jul. 91(1):76-86. [Medline].

  8. Yoshizawa N, Yamakami K, Fujino M, et al. Nephritis-associated plasmin receptor and acute poststreptococcal glomerulonephritis: characterization of the antigen and associated immune response. J Am Soc Nephrol. 2004 Jul. 15(7):1785-93. [Medline].

  9. Oda T, Yamakami K, Omasu F, et al. Glomerular plasmin-like activity in relation to nephritis-associated plasmin receptor in acute poststreptococcal glomerulonephritis. J Am Soc Nephrol. 2005 Jan. 16(1):247-54. [Medline].

  10. Poon-King R, Bannan J, Viteri A, Cu G, Zabriskie JB. Identification of an extracellular plasmin binding protein from nephritogenic streptococci. J Exp Med. 1993 Aug 1. 178(2):759-63. [Medline]. [Full Text].

  11. Parra G, Rodríguez-Iturbe B, Batsford S, et al. Antibody to streptococcal zymogen in the serum of patients with acute glomerulonephritis: a multicentric study. Kidney Int. 1998 Aug. 54(2):509-17. [Medline].

  12. Cu GA, Mezzano S, Bannan JD, Zabriskie JB. Immunohistochemical and serological evidence for the role of streptococcal proteinase in acute post-streptococcal glomerulonephritis. Kidney Int. 1998 Sep. 54(3):819-26. [Medline].

  13. García R, Rubio L, Rodríguez-Iturbe B. Long-term prognosis of epidemic poststreptococcal glomerulonephritis in Maracaibo: follow-up studies 11-12 years after the acute episode. Clin Nephrol. 1981 Jun. 15(6):291-8. [Medline].

  14. Perlman LV, Herdman RC, Kleinman H, Vernier RL. Poststreptococcal glomerulonephritis. A ten-year follow-up of an epidemic. JAMA. 1965 Oct 4. 194(1):63-70. [Medline].

  15. Kandoth PW, Agarwal GJ, Dharnidharka VR. Acute renal failure in children requiring dialysis therapy. Indian Pediatr. 1994 Mar. 31(3):305-9. [Medline].

  16. Baldwin DS, Gluck MC, Schacht RG, Gallo G. The long-term course of poststreptococcal glomerulonephritis. Ann Intern Med. 1974 Mar. 80(3):342-58. [Medline].

  17. World Health Organization. Countries. Available at http://www.who.int/countries/en/. Accessed: January 10, 2008.

  18. Treser G, Semar M, McVicar M, Franklin M, Ty A, Sagel I, et al. Antigenic streptococcal components in acute glomerulonephritis. Science. 1969 Feb 14. 163(868):676-7. [Medline].

  19. Balter S, Benin A, Pinto SW, et al. Epidemic nephritis in Nova Serrana, Brazil. Lancet. 2000 May 20. 355(9217):1776-80. [Medline].

  20. Francis AJ, Nimmo GR, Efstratiou A, Galanis V, Nuttall N. Investigation of milk-borne Streptococcus zooepidemicus infection associated with glomerulonephritis in Australia. J Infect. 1993 Nov. 27(3):317-23. [Medline].

  21. McIntosh RM, Kulvinskas C, Kaufman DB. Alteration of the chemical composition of human immunoglobulin G by Streptococcus pyogenes. J Med Microbiol. 1971 Nov. 4(4):535-8. [Medline].

  22. Gewurz H, Pickering RJ, Naff G, Snyderman R, Mergenhagen SE, Good RA. Decreased properdin activity in acute glomerulonephritis. Int Arch Allergy Appl Immunol. 1969. 36(6):592-8. [Medline].

  23. Wyatt RJ, Forristal J, West CD, Sugimoto S, Curd JG. Complement profiles in acute post-streptococcal glomerulonephritis. Pediatr Nephrol. 1988 Apr. 2(2):219-23. [Medline].

  24. Wyatt RJ, McAdams AJ, Forristal J, Snyder J, West CD. Glomerular deposition of complement-control proteins in acute and chronic glomerulonephritis. Kidney Int. 1979 Oct. 16(4):505-12. [Medline].

  25. Hisano S, Matsushita M, Fujita T, Takeshita M, Iwasaki H. Activation of the lectin complement pathway in post-streptococcal acute glomerulonephritis. Pathol Int. 2007 Jun. 57(6):351-7. [Medline].

  26. Derrick CW, Reeves MS, Dillon HC Jr. Complement in overt and asymptomatic nephritis after skin infection. J Clin Invest. 1970 Jun. 49(6):1178-87. [Medline]. [Full Text].

  27. Levy M, Sich M, Pirotzky E, Habib R. Complement activation in acute glomerulonephritis in children. Int J Pediatr Nephrol. 1985 Jan-Mar. 6(1):17-24. [Medline].

  28. Sjöholm AG. Complement components and complement activation in acute poststreptococcal glomerulonephritis. Int Arch Allergy Appl Immunol. 1979. 58(3):274-84. [Medline].

  29. Strife CF, McAdams AJ, McEnery PT, Bove KE, West CD. Hypocomplementemic and normocomplementemic acute nephritis in children: a comparison with respect to etiology, clinical manifestations, and glomerular morphology. J Pediatr. 1974 Jan. 84(1):29-38. [Medline].

  30. Tina LU, D'Albora JB, Antonovych TT, Bellanti JA, Calcagno PL. Acute glomerulonephritis associated with normal serum B1C-globulin. Am J Dis Child. 1968 Jan. 115(1):29-36. [Medline].

  31. West CD, McAdams AJ. Serum and glomerular IgG in poststreptococcal glomerulonephritis are correlated. Pediatr Nephrol. 1998 Jun. 12(5):392-6. [Medline].

  32. Eison TM, Ault BH, Jones DP, Chesney RW, Wyatt RJ. Post-streptococcal acute glomerulonephritis in children: clinical features and pathogenesis. Pediatr Nephrol. 2011 Feb. 26(2):165-80. [Medline].

  33. Ilyas M, Tolaymat A. Changing epidemiology of acute post-streptococcal glomerulonephritis in Northeast Florida: a comparative study. Pediatr Nephrol. 2008 Jul. 23(7):1101-6. [Medline].

  34. Longcope WT, O'Brien DP, McGuire J, Hansen OC, Denny ER. Relationship of acute infections to glomerular nephritis. J Clin Invest. 1927 Dec. 5(1):7-30. [Medline]. [Full Text].

  35. Dixon FJ, Feldman JD, Vazquez JJ. Experimental glomerulonephritis. The pathogenesis of a laboratory model resembling the spectrum of human glomerulonephritis. J Exp Med. 1961 May 1. 113:899-920. [Medline]. [Full Text].

  36. Wong W, Lennon DR, Crone S, Neutze JM, Reed PW. Prospective population-based study on the burden of disease from post-streptococcal glomerulonephritis of hospitalised children in New Zealand: epidemiology, clinical features and complications. J Paediatr Child Health. 2013 Oct. 49(10):850-5. [Medline].

  37. Wu SH, Liao PY, Yin PL, Zhang YM, Dong L. Elevated expressions of 15-lipoxygenase and lipoxin A4 in children with acute poststreptococcal glomerulonephritis. Am J Pathol. 2009 Jan. 174(1):115-22. [Medline]. [Full Text].

  38. Lange K, Azadegan AA, Seligson G, Bovie RC, Majeed H. Asymptomatic poststreptococcal glomerulonephritis in relatives of patients with symptomatic glomerulonephritis. Diagnostic value of endostreptosin antibodies. Child Nephrol Urol. 1988-1989. 9(1-2):11-5. [Medline].

  39. Seligson G, Lange K, Majeed HA, Deol H, Cronin W, Bovie R. Significance of endostreptosin antibody titers in poststreptococcal glomerulonephritis. Clin Nephrol. 1985 Aug. 24(2):69-75. [Medline].

  40. Rodriguez-Iturbe B, Musser JM. The current state of poststreptococcal glomerulonephritis. J Am Soc Nephrol. 2008 Oct. 19(10):1855-64. [Medline].

  41. Greenbaum LA, Kerlin BA, Van Why S, Punzalan RC, Trost BA, Pan CG, et al. Concurrent poststreptococcal glomerulonephritis and autoimmune hemolytic anemia. Pediatr Nephrol. 2003 Dec. 18(12):1301-3. [Medline].

  42. Lau KK, Hastings MC, Delos Santos NM, Gaber LW, Ault BH. A child with post-streptococcal glomerulonephritis complicated by Coombs positive autoimmune haemolytic anemia. Internet J Nephro. 2007.

  43. Haas M, Racusen LC, Bagnasco SM. IgA-dominant postinfectious glomerulonephritis: a report of 13 cases with common ultrastructural features. Hum Pathol. 2008 Sep. 39(9):1309-16. [Medline].

  44. Pais PJ, Kump T, Greenbaum LA. Delay in diagnosis in poststreptococcal glomerulonephritis. J Pediatr. 2008 Oct. 153(4):560-4. [Medline].

  45. Tokura T, Morita Y, Yorimitsu D, Horike H, Sasaki T, Kashihara N. Co-occurrence of poststreptococcal reactive arthritis and acute glomerulonephritis. Mod Rheumatol. 2008. 18(5):526-8. [Medline].

  46. Lewy JE, Salinas-Madrigal L, Herdson PB, Pirani CL, Metcoff J. Clinico-pathologic correlations in acute poststreptococcal glomerulonephritis. A correlation between renal functions, morphologic damage and clinical course of 46 children with acute poststreptococcal glomerulonephritis. Medicine (Baltimore). 1971 Nov. 50(6):453-501. [Medline].

  47. Dodge WF, Spargo BH, Travis LB, et al. Poststreptococcal glomerulonephritis. A prospective study in children. N Engl J Med. 1972 Feb 10. 286(6):273-8. [Medline].

  48. Sarkissian A, Papazian M, Azatian G, Arikiants N, Babloyan A, Leumann E. An epidemic of acute postinfectious glomerulonephritis in Armenia. Arch Dis Child. 1997 Oct. 77(4):342-4. [Medline]. [Full Text].

  49. Bingler MA, Ellis D, Moritz ML. Acute post-streptococcal glomerulonephritis in a 14-month-old boy: why is this uncommon?. Pediatr Nephrol. 2007 Mar. 22(3):448-50. [Medline].

  50. Li Volti S, Furnari ML, Garozzo R, Santangelo G, Mollica F. Acute post-streptococcal glomerulonephritis in an 8-month-old girl. Pediatr Nephrol. 1993 Dec. 7(6):737-8. [Medline].

  51. Burke EC, Titus JL. Poststreptococcal acute glomerulonephritis in children. Med Clin North Am. 1966 Jul. 50(4):1141-58. [Medline].

  52. Travis LB, Dodge WF, Beathard GA, Spargo BH, Lorentz WB, Carvajal HF, et al. Acute glomerulonephritis in children. A review of the natural history with emphasis on prognosis. Clin Nephrol. 1973 May-Jun. 1(3):169-81. [Medline].

  53. Rodríguez-Iturbe B. Epidemic poststreptococcal glomerulonephritis. Kidney Int. 1984 Jan. 25(1):129-36. [Medline].

  54. Bouhard BH, Travis LB. Acute postinfectious glomerulonephritis. Eldeman CM, Ed. Pediatric Kidney Disease. 2nd ed. Boston, Mass: Little, Brown and Company; 1992. 1199-1221.

  55. Choyke PL, Bluth EI, Bush WH Jr, et al, and the Expert Panel on Urologic Imaging. ACR Appropriateness Criteria: hematuria. [online publication]. Reston,Va: American College of Radiology (ACR); 2005.

  56. Jennings RB, Earle DP. Post-streptococcal glomerulo-nephritis: histopathologic and clinical studies of the acute, subsiding acute and early chronic latent phases. J Clin Invest. 1961 Aug. 40:1525-95. [Medline]. [Full Text].

  57. Anand SK, Trygstad CW, Sharma HM, Northway JD. Extracapillary proliferative glomerulonephritis in children. Pediatrics. 1975 Sep. 56(3):434-42. [Medline].

  58. Roy S 3rd, Murphy WM, Arant BS Jr. Poststreptococcal crescenteric glomerulonephritis in children: comparison of quintuple therapy versus supportive care. J Pediatr. 1981 Mar. 98(3):403-10. [Medline].

  59. Wong W, Morris MC, Zwi J. Outcome of severe acute post-streptococcal glomerulonephritis in New Zealand children. Pediatr Nephrol. 2009 May. 24(5):1021-6. [Medline].

  60. Fish AJ, Herdman RC, Michael AF, Pickering RJ, Good RA. Epidemic acute glomerulonephritis associated with type 49 streptococcal pyoderma. II. Correlative study of light, immunofluorescent and electron microscopic findings. Am J Med. 1970 Jan. 48(1):28-39. [Medline].

  61. McCluskey RT, Vassalli P, Gallo G, Baldwin DS. An immunofluorescent study of pathogenic mechanisms in glomerular diseases. N Engl J Med. 1966 Mar 31. 274(13):695-701. [Medline].

  62. Yoshizawa N. Acute glomerulonephritis. Intern Med. 2000 Sep. 39(9):687-94. [Medline].

  63. Carapetis JR, Steer AC, Mulholland EK, Weber M. The global burden of group A streptococcal diseases. Lancet Infect Dis. 2005 Nov. 5(11):685-94. [Medline].

  64. Shank JC, Powell TA. A five-year experience with throat cultures. J Fam Pract. 1984 Jun. 18(6):857-63. [Medline].

  65. Centor RM, Witherspoon JM, Dalton HP, Brody CE, Link K. The diagnosis of strep throat in adults in the emergency room. Med Decis Making. 1981. 1(3):239-46. [Medline].

  66. McIsaac WJ, White D, Tannenbaum D, Low DE. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ. 1998 Jan 13. 158(1):75-83. [Medline]. [Full Text].

  67. Edmonson MB, Farwell KR. Relationship between the clinical likelihood of group a streptococcal pharyngitis and the sensitivity of a rapid antigen-detection test in a pediatric practice. Pediatrics. 2005 Feb. 115(2):280-5. [Medline].

  68. American Academy of Pediatrics, Committee in Infectious Diseases. Group A streptococcal infections. The Red Book. Elk Grove Village, Ill: American Academy of Pediatrics; 2000. 526-92.

  69. Dale JB, Penfound T, Chiang EY, Long V, Shulman ST, Beall B. Multivalent group A streptococcal vaccine elicits bactericidal antibodies against variant M subtypes. Clin Diagn Lab Immunol. 2005 Jul. 12(7):833-6. [Medline]. [Full Text].

  70. Ahn SY, Ingulli E. Acute poststreptococcal glomerulonephritis: an update. Curr Opin Pediatr. 2008 Apr. 20(2):157-62. [Medline].

  71. Batsford SR, Mezzano S, Mihatsch M, Schiltz E, Rodríguez-Iturbe B. Is the nephritogenic antigen in post-streptococcal glomerulonephritis pyrogenic exotoxin B (SPE B) or GAPDH?. Kidney Int. 2005 Sep. 68(3):1120-9. [Medline].

  72. Cole BR, Salinas-Madrigal L. Acute Proliferative glomerulonephritis and crescentic glomerulonephritis. Barratt TM, Avner ED, Harmon WE, eds. Pediatric Nephrology. 4th ed. Philadelphia, Pa: Lippincott; 1999. 669-89.

  73. Cu GA, Mezzano S, Bannan JD, Zabriskie JB. Immunohistochemical and serological evidence for the role of streptococcal proteinase in acute post-streptococcal glomerulonephritis. Kidney Int. 1998 Sep. 54(3):819-26. [Medline].

  74. [Guideline] Finnish Medical Society Duodecim. Nephropathia epidemica (NE). EBM Guidelines. Evidence-Based Medicine [Internet]. Apr 4 2007. [Full Text].

  75. Kambham N. Postinfectious glomerulonephritis. Adv Anat Pathol. 2012 Sep. 19(5):338-47. [Medline].

  76. Moroni G, Pozzi C, Quaglini S, Segagni S, Banfi G, Baroli A. Long-term prognosis of diffuse proliferative glomerulonephritis associated with infection in adults. Nephrol Dial Transplant. 2002 Jul. 17(7):1204-11. [Medline].

  77. Nasr SH, Markowitz GS, Stokes MB, Said SM, Valeri AM, D'Agati VD. Acute postinfectious glomerulonephritis in the modern era: experience with 86 adults and review of the literature. Medicine (Baltimore). 2008 Jan. 87(1):21-32. [Medline].

  78. Oda T, Yoshizawa N, Yamakami K, Sakurai Y, Takechi H, Yamamoto K. The role of nephritis-associated plasmin receptor (NAPlr) in glomerulonephritis associated with streptococcal infection. J Biomed Biotechnol. 2012. 2012:417675. [Medline].

  79. Poon-King R, Bannan J, Viteri A, Cu G, Zabriskie JB. Identification of an extracellular plasmin binding protein from nephritogenic streptococci. J Exp Med. 1993 Aug 1. 178(2):759-63. [Medline].

  80. Ramchandani P, Kisler T, Francis IR, et al, and The Expert Panel on Urologic Imaging. ACR Appropriateness Criteria: hematuria. [online publication]. Reston, Va: American College of Radiology (ACR); 2008.

  81. Rodríguez-Iturbe B. Nephritis-associated streptococcal antigens: where are we now?. J Am Soc Nephrol. 2004 Jul. 15(7):1961-2. [Medline].

  82. Yamakami K, Yoshizawa N, Wakabayashi K, Takeuchi A, Tadakuma T, Boyle MD. The potential role for nephritis-associated plasmin receptor in acute poststreptococcal glomerulonephritis. Methods. 2000 Jun. 21(2):185-97. [Medline].

  83. Yoshizawa N, Yamakami K, Oda T. Nephritogenic antigen for acute poststreptococcal glomerulonephritis. Kidney Int. 2006 Mar. 69(5):942-3; author reply 942. [Medline].

 
Previous
Next
 
Schematic representation of proposed mechanisms involved in the development of acute poststreptococcal glomerulonephritis (APSGN).MES: mesangial cell; END: endothelial cell; PMN: polymorphonuclear cell; MΦ: macrophage; T: T lymphocyte; GMB: glomerular basement membrane; C: complement; Anti-NAPlr-Ab: Anti-NAPlr-antibody.Courtesy of open access article, "The Role of Nephritis-Associated Plasmin Receptor (NAPlr) in Glomerulonephritis Associated with Streptococcal Infection." Oda T, Yoshizawa N, Yamakami K, et al. Journal of Biomedicine and Biotechnology, 2012; doi: 10.1155/417675.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.