## Basic introduction:
- It is an inflammatory renal disease that frequently occurs as a late complication of pharyngitis or skin infections due to a nephritogenic strain of β-hemolytic streptococci.
- It is the major subtype of the Acute Glomerulonephritis (AGN) constituting 80-90% of all AGN cases
- It is one of the diseases of the acute nephritic syndrome in which inflammation of the glomerulus is characterized by proliferation of cellular elements secondary to an immunologic mechanism.
- Generally, APSGN has a good prognosis with early detection and treatment. Spontaneous improvement begins within 7 days, edema resolution is within 5-10 days and hypertension resolution is within 2-3 weeks. Microscopic hematuria may remain for many years.
## Pathology of APSGN:
- There is infection by nephritogenic strain of β-hemolytic streptococci
- Immune system is elicited and immune complexes are formed
- There is activation of complement system and recruitment of leukocytes
- Cytokines and proliferative factors are secreted
- Glomerular basement membrane (GBM) is damaged
- This results in hematuria, proteinuria and the presence of RBC casts
- Cytokines and proliferative factors also stimulate the growth and proliferation of endothelial cells causing the blockage of renal capillaries which in turn leads to oliguria, sodium and water retention as well as hypervolemia, edema, hypertension, heart failure, renal failure and encephalopathy.
## Epidemiology and Statistics:
- Mortality rate from APSGN –< 0.5% of those who get the disease
- 8% of the children affected by APSGN develop chronic renal disease (hence it is necessary for these children to be followed up by the nephrologist/urologist)
- Recovery rate>95%
- Children tends to recover faster than adults
## Possible complications of APSGN:
- Nephrotic syndrome (due to the loss of too much protein)
- Acute kidney failure
- Chronic glomerulonephritis