1. POST-STREPTOCOCCAL GLOMERULONEPHRITIS Falcones,K; Ortega,JJ; Ricart,E; Molina,R Hospital Virgen de los Lirios de Alcoy
INTRODUCTION:
The post-infectious acute glomerulonephritis (IPNG) is an immune-based pathological process that results in a non-suppurative inflammatory lesion predominantly glomerular. Although prevalence has decreased, it is still the most frequent cause of childhood nephritic syndrome.
After infection with SBGA, there is a latency period of clinical onset of two weeks in the case of upper respiratory infection and 4 weeks after skin infections. However, in non-estroptococcal forms, nephropathy is simultaneous to the infectious process.
CLINICAL CASE:
A ten-year-old girl who has had acute tonsillitis for two years. The first episode of amygdalar infection was in March 2016, where it was treated with AZITROMYCIN 200 MG IN 5 ML / 1 SUSP ORAL BOTTLE OF 30 ML, the patient presented improvement, but during that year she relapsed three times receiving the same treatment. On 18/04 she went to the pediatrician's outpatient clinic for general malaise, accompanied by epigastric pain, nausea and vomiting, with fever associated with left lateral neck pain, pain in the right ankle and facial edema, especially at the infraorbital level. SAT: 98%. FC: 101 lpm. Combur test: Turbid urine. Proteinuria and microscopic hematuria.

2. The routine analysis reports in the biochemistry: Uric acid 13
The routine analysis reports in the biochemistry: Uric acid 13.6 mg / dL, Creatinine 2.06 mg / dL, PCR 4.4 mg / dL, ASLO 1088 UIml. Hemogram: Hb g / dL, hematocrit 34%, leukocytes miles / μL, absolute neutrophils miles / L. Proteinogram: fraction of albumins 45.70%; proteins of the C3 complement system <4.0 mg / dl and C mg / dl. Urine: urinary sediment approximately 100% dysmorphic red blood cells, some hematic and granular cylinders, intense microhematuria, moderate bacteryruria. Urine biochemistry: Albumin , albumin / creatinine 1547 mg / g, Protein mg / dl, protein / creatinine 2041 mg / g.
DISCUSSION
The patient was admitted with a diagnosis of nephritic syndrome with a high suspicion of acute post-streptococcal glomerulonephritis due to a previous episode of pharyngotonsillitis and low C3. Given the presence of edema and high BP, along with moderate-severe IRA, fluid restriction (approximately 400ml / m2 / day), low-sodium diet and strict control of diruesis are initiated. Precise administration of furosemide during the first three days.We proceed to hospital discharge for good evolution with analytical results: Total protein 6.3 g / dL; albumin 3.1 g / dL; urea 217 mg / dL; creatinine 1.72 mg / dL; PCR mg / dL; ASLO 1088 IU / ml; protein in urine 217 mg / dL, Protein / Creatinine (urine) 1043 mg / g; rest of the parameters within normality.
CONCLUSION We proceed to hospital discharge for good evolution with analytical results: Total protein 6.3 g / dL; albumin 3.1 g / dL; urea 217 mg / dL; creatinine 1.72 mg / dL; PCR 15.3 mg / dL; ASLO 1088 IU / ml; protein in urine 217 mg / dL, Protein / Creatinine (urine) 1043 mg / g; rest of the parameters within normality.