Rapidly progressive glomerulonephritis in adolescents – aetiology and treatment based on case reports
Department of Paediatrics, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland. Head: Associate Professor Katarzyna Ziora, MD, PhD
Correspondence: Beata Banaszak, Department of Paediatrics, 3 Maja 13/15, 41-800 Zabrze, Poland, tel./fax: +48 32 370 42 83, +48 32 370 42 92, e-mail: beata.banaszak@op.pl
Pediatr Med Rodz 2017, 13 (2), p. 246–252
DOI: 10.15557/PiMR.2017.0026
ABSTRACT

Rapidly progressive glomerulonephritis is a disease characterised by an abrupt drop in glomerular filtration rate in a short period of time, which is caused by crescent formation seen in at least 50% of glomeruli. Two cases presented below illustrate rapid progressive glomerulonephritis in adolescents as a disease of heterogeneous aetiology that can develop both in the course of primary glomerulopathies and glomerulopathies secondary to systemic vasculitis. In the first case of an 11-year-old girl, nephritic syndrome with renal failure was accompanied by the presence of anti-myeloperoxidase antibodies in the serum, which in combination with the histopathological picture of the kidneys indicating pauci-immune rapidly progressive glomerulonephritis was the basis for the diagnosis of renal limited vasculitis. In the second case of a 16-year-old boy, an adverse course of acute post-streptococcal glomerulonephritis with features of severe and persistent glomerular filtration impairment was an indication for the verification of the diagnosis and identification of rapidly progressive glomerulonephritis based on a biopsy examination. Prompt diagnosis and inclusion of combined immunosuppressive therapy provided the chance to preserve renal function.

Keywords: rapidly progressive glomerulonephritis, renal limited vasculitis, acute glomerulonephritis, adolescents