What are the manifestations of pediatric acute glomerulonephritis

  The clinical manifestations of the disease vary widely, with the milder cases being “subclinical”, i.e., without specific clinical manifestations except for abnormal laboratory tests; the more severe cases may be complicated by severe circulatory congestion, hypertensive encephalopathy, and acute renal failure.  Typical cases 1. History of prodromal disease: About 10 days before the onset of the disease, there is often a history of streptococcal prodromal infection such as upper respiratory tract infection and tonsillitis; for those with skin impetigo as the prodromal history, the prodromal period is slightly longer, about 2 to 4 weeks.  2.Oedema: Initially, eyelids and face are predominant, gradually descending to the extremities in a non-depressed manner; combined ascites and pleural effusion are rare.  3. Urine volume: The decrease in urine volume is parallel to edema, and the less urine volume, the more edema. The standard of little urine is <400ml per day for school-age children, <300ml for preschool children, <200ml for infants and toddlers or less than 250ml/m2 per day; the standard of no urine is <50ml/m2 per day. Hematuria: Hematuria: it is often the first symptom of the disease, and almost all patients have hematuria, of which the rate of visual hematuria is about 40%; it turns to microscopic hematuria after 1 to 2 weeks. The majority of patients with mild disease do not have hematuria.  5. Proteinuria: almost all patients have positive urine protein, but proteinuria is generally not serious, between 0.5 and 3.5 g/d. 6. Hypertension: seen in 70% of cases. Hypertension is seen in 30% to 80% of cases, due to water and sodium retention and blood volume expansion, generally mild or moderate increase. In most cases, the blood pressure decreases to normal after 1 to 2 weeks with diuresis, but if it does not decrease, the possibility of an acute attack of chronic nephritis should be considered. Different age groups have different criteria for hypertension: school-age children ≥ (130/90mmHg); preschool children ≥ (120/80mmHg); infants and children ≥ (110/70mmHg) for hypertension.  7, renal impairment: often have transient azotemia, blood creatinine and urea nitrogen mildly elevated, after a few days of diuresis, azotemia can return to normal. In a few patients, acute renal failure may occur; 8. Laboratory tests: transient anemia, elevated anti-chain "O", elevated ESR, decreased complement, etc.