1, clinical manifestations
Acute nephritis more common in children, more men than women. The typical symptoms of streptococcal infection is generally 1 to 3 weeks (an average of 10 days or so) onset. The incubation period is equivalent to the initial pathogenic antigen produced after immunization induce immune complex time required for respiratory tract infection the incubation period shorter than the skin infections. The disease begins abruptly, with varying severity.
Zheng Jian edema, hematuria, hypertension, and body fatigue, do not think of eating, back pain, dizziness and so on. Edema appearance rate of about 80% ~ 90%, while only early morning light eyelid edema, in severe cases can affect the body. There was about 40% of the hematuria, urinary Secheng washing meat, water samples, in general no obvious urinary symptoms, gross hematuria for 1 to 2 weeks is transferred to the microscopic hematuria. Blood pressure found in 80% of the cases, generally mild or moderate blood pressure. Some cases may occur in the acute phase of acute congestive heart failure, hypertensive encephalopathy, acute renal failure and other serious complications. The clinical manifestations of atypical cases can no edema, hypertension and gross hematuria. Across streptococcal infection only in the urine microscopic hematuria discovered on routine examination, light by sub-acute only in the C3 urine and blood abnormalities. Typical was the performance of acute nephritic syndrome.
2, laboratory and other tests
1, urine examination: routine urine shows red blood cells, mostly deformed red blood cells; proteinuria, 75% of patients in sufficient quantities is less than 24h urinary protein 3.0g; common renal tubular epithelial cells, white blood cells, transparent and granular cast, in addition to visible red tube, showing glomerular bleeding exudative inflammation is an important characteristic of acute nephritis.
2, blood examination: white blood cell can be a normal increase, mild anemia, as is normal pigment cell anemia, increased erythrocyte sedimentation rate in the acute phase soon.
3, renal function and blood biochemical tests: acute phase of glomerular filtration rate has dropped, the clinical manifestations of a transient azotemia. Potassium, chlorine may be slightly elevated, serum sodium decreased slightly, a slight drop in plasma proteins.
4, fibrin degradation products (FDP) measured: blood, urine FDP measurement can be positive.
5, immunological examination:
(1) Anti-streptolysin O antibody (ASO): The positive rate of 50% ~ 80%. Streptococcal infection usually 2 ~ 3 weeks after the emergence of 3 ~ 5 weeks titer reached its peak, the latter gradually decreased.
(2) Anti-deoxyribonuclease B (anti-DNAse B) and anti-hyaluronidase (anti-HASe): from the abscess caused by acute nephritis patients have a higher positive rate, there are more than two-fold higher titers When prompted with streptococcal infection in the near future.