Varied Presentations of Post-Infectious Acute Glomerulonephritis in Children: A Descriptive Study

Post infectious acute glomerulonephritis (AGN) remains a major cause of acute kidney injury in children in low- and middle-income countries. While most cases follow streptococcal infections and present with oedema, hypertension, and haematuria, some manifest atypically with nephrotic syndrome or severe renal dysfunction.
The Objective were to describe the clinical, laboratory, imaging, and histopathological characteristics of post-infectious AGN in Sri Lankan children and evaluate short term outcomes, including atypical presentations.
A one-year descriptive study was conducted at two tertiary paediatric centres. Sixty-six children aged 2–16 years with AGN were enrolled. Data on clinical presentation, laboratory tests (CBC, renal/liver function, electrolytes, urinalysis, C3/C4, ASO titre), imaging, and renal biopsy (in selected cases) were collected. Supportive therapy, dialysis, and immunosuppressive use were recorded. Follow-up was done at 1, 2, 3, 6, and 12 months.
Mean age was 9.0 ± 2.9 years; 57.6% were male. Oedema and hypertension occurred in 95.5%, macroscopic haematuria in 60.6%, and oliguria in 48.5%. Low C3 was found in 66.7% and elevated ASO titres in 80.3%. Nephrotic-range proteinuria occurred in 28.8%. Dialysis was required in 13.6%. Corticosteroids and cyclophosphamide were used in 30.3% and 9.1%, respectively. All achieved full recovery within 12 months; atypical AGN was seen in 6.1%.
Post-infectious AGN in children is generally self-limiting. Typical cases recover with supportive care, while atypical forms may require selective immunosuppression. Early diagnosis and appropriate management yield excellent outcomes.