Abstract

NOGUERA-VALVERDE, Ronald Armando. Hypertensive encephalopathy due to acute post-streptococcal glomerulonephritis. Bol. Med. Hosp. Infant. Mex. [online]. 2009, vol.66, n.3, pp.260-264. ISSN 1665-1146.

Introduction. Acute post-streptococcal glomerulonephritis (APS-GN) is the leading cause of nephritic syndrome in children and has a broad spectrum of clinical presentation ranging from asymptomatic cases to acute renal failure and encephalopathy. Most cases are sporadic although the disease may occur in epidemic form, mainly related to poor sanitary conditions. Hypertensive encephalopathy is a severe complication, but there is a good outcome with appropriate treatment. Case report. We describe the case of a previously healthy 10-year-old male with a history of pharyngitis 1 week before his arrival to the emergency room. He presented with altered consciousness, partial seizures, hypertension and hematuria. Cranial computed tomography was performed and showed no edema, mass or hemorrhage; antistreptolysin O serum titers were elevated. He was treated according to hypertensive encephalopathy due to APSGN, with a favorable outcome. Differential diagnosis should include cerebral vascular diseases, intracranial tumors, central nervous system infections and toxic metabolic disturb ances. Conclusion. APSGN should be suspected in any child with history of pharyngitis and sudden onset of hypertensive encephalopathy.

Keywords : Glomerulonephritis; hypertensive encephalopathy; seizures; streptococcal infections; antistreptolysin, O.