Pediatric protracted glomerulonephritis
Introduction
Introduction to prolonged glomerulonephritis in children Prolonged glomerulonephritis is referred to as prolonged nephritis. The course of the disease is delayed but the systemic symptoms are mild. In glomerular diseases, in addition to the more common acute glomerulonephritis, nephrotic syndrome, solitary hematuria, solitary proteinuria, there are some chronic glomerulonephritis, ranging from mild to severe, including protracted Nephritis and chronic nephritis, the concept of prolonged nephritis is not uniform, China's Pediatric Kidney Disease Coordination Group will delay the course of acute nephritis more than 1 year, such as without hypertension or renal insufficiency or anemia, collectively referred to as protracted nephritis. basic knowledge The proportion of illness: the incidence rate is about 0.005%-0.008% Susceptible people: children Mode of infection: non-infectious Complications: chronic nephritis
Cause
Causes of prolonged glomerulonephritis in children
(1) Causes of the disease
The etiology is complicated, and it is mostly immune complex nephritis caused by repeated infections such as bacteria and viruses.
(two) pathogenesis
Most of the renal pathological changes were mild, with focal nephritis or mesangial proliferative nephritis without crescent formation, and only a few cases showed serious pathological changes such as membranous or membrane proliferative nephritis.
Prevention
Protracted glomerulonephritis prevention in children
Should prevent and control infection, reasonable time, avoid overwork, preventive measures and acute nephritis, such as active prevention of streptococcal infection, should strengthen exercise on weekdays, pay attention to skin clean and hygienic, to reduce respiratory and skin infections, such as infection should be timely Thorough treatment, urine routine should be checked 2 to 3 weeks after infection, and abnormalities are found at the same time.
Complication
Pediatric prolonged glomerulonephritis complications Complications chronic nephritis
A few can develop into chronic nephritis.
Symptom
Pediatric prolonged glomerular nephritis symptoms common symptoms edema eyelid edema proteinuria hematuria hypertension
Often manifested as persistent proteinuria with microscopic edema without obvious clinical symptoms, many complained of mild edema of the eyelids in the morning, every time the symptoms of fatigue, infection, etc. were temporarily aggravated, some patients were asymptomatic, only in urine screening Under the microscope, hematuria, proteinuria, occasional edema, no hypertension, normal renal function, in some cases, there is a clear history of acute nephritis, but the abnormal urine continues for more than 1 year; in addition, there are still insidious onset, Sometimes it is accidentally discovered urinary abnormalities, the course of the disease is often difficult to estimate, but after follow-up observation for more than half a year, the pathological changes of prolonged nephritis are generally non-specific focal nephritis or mesangial proliferative nephritis; very few are more serious pathology Type, such as membranous or membrane proliferative nephritis.
Examine
Examination of prolonged glomerulonephritis in children
Urine routine see red blood cells (+ ~ ++), protein (+ ~ ++), and a little granular cast, a normal renal function, normal complement and urinary fibrinogen, B-ultrasound, ECG, X-ray examination generally no special Find.
Diagnosis
Diagnosis and differential diagnosis of prolonged glomerulonephritis in children
In 1981, China's Pediatric Kidney Disease Research Collaboration Group stated:
1 has a clear history of acute nephritis, microscopic examination of hematuria and / or proteinuria for more than 1 year, without renal insufficiency or hypertension;
2 There is no clear hematuria and proteinuria in the history of acute nephritis, clinical observation for more than half a year, without renal insufficiency or hypertension, the above can be diagnosed as the disease, so the following diagnostic methods should be noted:
1. For patients with acute nephritis, patients should be followed up regularly, and renal function should be monitored. If necessary, renal ultrasound, intravenous pyelography, etc. should be performed to guide the treatment to determine the nature and severity of renal lesions, and to judge the prognosis. Cases should be confirmed by renal biopsy.
2. Patients with abnormal urine found in the census: A renal function test is required to make a diagnostic evaluation, and a renal biopsy is necessary to confirm the diagnosis if necessary.
Must be associated with the recovery period of acute nephritis, or early identification of chronic nephritis, if necessary, refer to the kidney map, renal ultrasound, intravenous pyelography, etc., if necessary, renal puncture should be performed to confirm the diagnosis.
