Poststreptococcal glomerulonephritis

Question 1

what is the definition of poststrep GN?

Answer 1

Nephritic syndrome that occurs after group A strep skin infection 3-6 weeks prior or throat infection 1-3 weeks prior

Question 2

what are the first line and gold standard investigations for post strep GN?

Answer 2

Streptozyme test:
Anti-streptolysin-o (throat)
Anti-hyaluronidase (throat and skin)
Anti-streptokinase
Anti Nicotinamide adenine dinucleotide (throat)
Anti-dnase b antibodies (throat and skin)
Serum C3 and C4 = can be low (immune complexes cause deposition of C3 and C4 in the subendothelial space in glomerulus)
Kidney biopsy not needed
Throat or skin culture may be done

Question 3

how is post strep GN managed?

Answer 3

Nifedipine (NOT ACEi as these cause hyperkalemia)
Loop diuretic
Oral penicillin if active infection