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Acute post-infectious glomerulonephritis 

Acute post-infectious glomerulonephritis
Chapter:
Acute post-infectious glomerulonephritis
Author(s):

Gabriella Moroni

and Claudio Ponticelli

DOI:
10.1093/med/9780199552887.003.0004
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date: 27 February 2021

Acute post-infectious glomerulonephritis (APIGN) is a primary glomerular disease characterized by intra-glomerular inflammation and cellular proliferation resulting from immunological events triggered by a variety of bacterial, viral, and protozoal infections. We use the term ‘primary’ to describe this disease since the kidney is the only organ directly involved in the disease, and extra-renal manifestations are generally the consequence of disturbed kidney function. The prototype of APIGN is post-streptococcal glomerulonephritis (PSGN) which most often occurs in children following a pharyngeal infection caused by a particular strain of streptococci and has a favorable outcome.

However in the last few decades the spectrum of APIGN has changed. The incidence of PSGN, particularly in its epidemic form, has progressively declined in industrialized countries. In many cases APIGN is caused today by other Gram-positive bacteria such as staphylococci or by Gram-negative bacteria. Moreover the disease tends to affect more and at a higher frequently adults with an immunocompromised background, due to alcoholism, diabetes, drug addiction, and/or viral hepatitis. Finally, while spontaneous recovery within few weeks is still the rule in children affected by the typical PSGN, the prognosis in immunodeficient adults is often severe and the response to treatment is uncommon. Therefore we will treat separately these two sub-types of acute glomerulonephritis.

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