Boy with glomerulonephritis caused by streptococcus

Ho Chi Minh City Quan, 12 years old, had difficulty breathing, edema, gained 4 kg in three days, high blood pressure, doctor diagnosed acute glomerulonephritis caused by streptococcus.

Three weeks ago, Quan had a fever and cough. His family thought he had a sore throat due to the hot weather, so they bought him fever-reducing medicine. His fever went away, he coughed a little, and he went to school as usual.

Last week, at first his face was slightly swollen, then he urinated less, gained weight quickly to 55 kg, and showed signs of edema all over his body. His family took Quan from Nha Trang to Ho Chi Minh City for examination. Upon landing at Tan Son Nhat airport, Quan had a headache and difficulty breathing and was rushed to Tam Anh General Hospital in Ho Chi Minh City.

On April 17, Dr. Nguyen Thi Minh Hien, Department of Pediatrics, said that the child patient came to the hospital with rapid breathing, generalized edema, gross hematuria, and blood pressure of 150/90 mmHG (normally below 120/80 mmHG). The child had pleural effusion, diffuse interstitial lung damage, and a urine test showed hematuria and nephrotic-range proteinuria. The doctor diagnosed the boy with acute post-streptococcal glomerulonephritis.

Glomerulonephritis occurs when the glomeruli are damaged, making it difficult for the kidneys to remove waste and fluid from the body, causing edema. In Quan's case, the disease was not detected early, leading to complications such as high blood pressure, difficulty breathing, and acute pulmonary edema.

"If uncontrolled, high blood pressure due to acute glomerulonephritis in children can lead to congestive heart failure, seizures, increased intracranial pressure, stroke, and cerebral hemorrhage like in adults," said Dr. Hien.

The child was treated with diuretics combined with calcium channel blockers to lower blood pressure and limit salt in the diet. By the fourth day, blood pressure was controlled, edema was reduced, weight gradually returned to normal, and blood tests showed no progression of kidney damage. The child was discharged and returned for a follow-up visit after a week.

Doctor Minh Hien examines Quan before discharge. Photo: Tue Diem — Doctor Minh Hien examines Quan before discharge. Photo: *Tue Diem*

Associate Professor, Dr. Vu Huy Tru, Head of Pediatrics Department, said that acute glomerulonephritis is a common kidney disease in children from 2 to 12 years old, related to acute respiratory infections or skin infections.

Symptoms often start suddenly, with generalized edema, oliguria, hematuria, hypertension, and life-threatening acute renal failure, acute heart failure, cerebral edema, and convulsions. If the patient is not diagnosed and treated properly, the child will develop early renal failure.

Dr. Tru noted that acute glomerulonephritis progresses rapidly and is prone to complications. As soon as a child has a high fever, a low temperature but the body is swollen, has abnormally rapid weight gain, urinates little, has blood in the urine, is tired, and has difficulty breathing, the family should take the child to see a doctor immediately.

Wisdom

* Patient name has been changed

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