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Clin Biochem 2022 Apr 9. Epub 2022 Apr 9.

Department of Pathology and Laboratory Medicine, Children's Hospital of Los Angeles, Los Angeles, CA, United States; Department of Clinical Pathology, Keck School of Medicine, University of Southern California, United States. Electronic address:

Over-the-counter (OTC) and direct-to-consumer (DTC) tests have been gaining popularity due to their potential to provide accurate and quick diagnostic results without any test order from healthcare professionals, while providing patients the opportunity to actively engage in their own health management. Group A streptococcus is a common transmissible pathogen that leads to acute pharyngitis. Accurate and timely diagnosis of Group A streptococcus pharyngitis is critical to urge patients to seek professional healthcare, to support antibiotic stewardship, to reduce disease transmission, and to prevent rare but potentially life-threatening complications such as acute rheumatic fever, rheumatic heart disease, and poststreptococcal glomerulonephritis. Read More

CEN Case Rep 2022 Apr 10. Epub 2022 Apr 10.

Department of Pediatrics, Hokkaido University Hospital, Hokkaido University Graduate School of Medicine, Kita 15-jo Nishi 7-Chome, Kita Ward, Sapporo, Hokkaido, Japan.

It is clinically possible for patients with Alport syndrome (AS) to suffer from poststreptococcal acute glomerulonephritis (PSAGN). However, there is only one report of such a patient, and he had end-stage kidney disease. Here, we describe an 8-year-old male with X-linked AS and chronic kidney disease (CKD) stage G2. Read More

Intern Med 2022 Mar 12. Epub 2022 Mar 12.

Department of Nephrology, Nippon Medical School, Japan.

A 44-year-old woman was admitted due to gross hematuria and progressive renal dysfunction. Poststreptococcal acute glomerulonephritis (PSAGN) was suspected due to her elevated anti-streptolysin O and anti-streptokinase titers and hypocomplementemia. A renal biopsy showed crescent formation and endocapillary hypercellularity with neutrophil infiltrate. Read More

Front Pediatr 2021 3;9:781106. Epub 2022 Feb 3.

Department of Nephrology, Rheumatology and Immunology, Hunan Children's Hospital, Changsha, China.

Henoch-Schönlein purpura (HSP)/ IgA vasculitis (IgAV) is the most common form of systemic vasculitis in children and often involves the skin, gastrointestinal tract, joints, and kidneys, though cardiac involvement rarely occurs. We report on a 6-year-old male child with HSP/IgAV who had renal and cardiac involvement at the initial stage of the disease and in whom we found an extremely rare coronary artery aneurysm. After administration of glucocorticoid combined with mycophenolate mofetil, the renal involvement improved, but the coronary artery aneurysm remained. Read More

Pathol Int 2022 Mar 11;72(3):200-206. Epub 2022 Feb 11.

Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.

This paper presents the case of a patient who developed acute kidney injury and nephrotic syndrome following streptococcal cutaneous infection. He presented with microhematuria, severe proteinuria and systemic edema 5 days after infection. Blood examination showed elevated creatinine level, hypocomplementemia, and elevated anti-streptolysin O level. Read More

BMC Nephrol 2022 02 5;23(1):56. Epub 2022 Feb 5.

Department of Nephrology and Blood Purification, Kidney Disease Center, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo, 193-0998, Japan.

Background: To date, a few case reports have described the association between poststreptococcal acute glomerulonephritis (PSAGN) and hemolytic anemia/thrombocytopenia, both with or without a pathology similar to that of thrombotic microangiopathy (TMA). However, the detailed mechanism leading to the complication of TMA in PSAGN patients remains to be clarified. In contrast, infection with neuraminidase-producing Streptococcus pneumoniae is a well-known cause of TMA, and it has been reported that transient positivity of the direct Coombs test is observed in up to 90% of such patients. Read More

Kidney Int Rep 2021 Nov 24;6(11):2782-2793. Epub 2021 Aug 24.

Centre for Chronic Disease, The University of Queensland, Queensland, Australia.

Introduction: We have previously showed that albuminuria was associated with low birthweight in young adults in a remote Australian Aboriginal community that has high rates of kidney disease. Here we describe the association of birthweight with incidence and progression of kidney disease over time.

Methods: Among 695 members of an Aboriginal community with recorded birthweights, urine albumin creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) were measured at ages 5 to 40 years, and follow-up values were measured or imputed again a median of 11. Read More

Immunol Res 2022 02 12;70(1):86-96. Epub 2021 Oct 12.

Department of Nephrology, The Second Xiangya Hospital/Central South University, No. 139 Renmin Middle Rd, Changsha, 410011, Hunan, China.

While β-hemolytic streptococcus (β-HS) infections are known to predispose patients to acute poststreptococcal glomerulonephritis, there is evidence that implicates α-hemolytic streptococcus (α-HS) in IgA nephropathy (IgAN). The alternative pathway of the complement system has also been implicated in IgAN. We aimed to explore the association between α-HS and complement activation in human tonsillar mononuclear cells (TMCs) in IgAN. Read More

PLoS Negl Trop Dis 2021 09 30;15(9):e0009751. Epub 2021 Sep 30.

Gold Coast University Hospital, Southport, Queensland, Australia.

Scabies has recently gained international attention, with the World Health Organization (WHO) recognizing it as a neglected tropical disease. The International Alliance for the Control of Scabies recently formed as a partnership of more than 15 different countries, with an aim to lead a consistent and collaborative approach to preventing and controlling scabies globally. Scabies is most prevalent in low-resource and low socioeconomic areas that experience overcrowding and has a particularly high prevalence in children, with an estimated 5% to 10% in endemic countries. Read More

Pediatr Nephrol 2022 Apr 21;37(4):833-841. Epub 2021 Sep 21.

Imaging Institute of Southern Switzerland EOC, Bellinzona, Switzerland.

Background: Kidney diseases are a recognized cause of posterior reversible leukoencephalopathy syndrome, usually abbreviated as PRES. The purpose of this review was to systematically address the association between acute postinfectious glomerulonephritis and PRES.

Methods: We performed a systematic review of the literature on acute postinfectious glomerulonephritis associated with PRES. Read More

R Soc Open Sci 2021 Mar 10;8(3):201991. Epub 2021 Mar 10.

Division of Molecular Microbiology, School of Life Sciences, University of Dundee, Dow Street, Dundee, DD1 5EH, UK.

, also known as Group A Streptococcus (GAS), is a Gram-positive human-exclusive pathogen, responsible for more than 500 000 deaths annually worldwide. Upon infection, GAS commonly triggers mild symptoms such as pharyngitis, pyoderma and fever. However, recurrent infections or prolonged exposure to GAS might lead to life-threatening conditions. Read More

J Am Soc Nephrol 2021 03 2;32(3):534-542. Epub 2021 Feb 2.

Department of Nephrology, Instituto Nacional de Nutrición y Ciencias Médicas "Salvador Zubirán" and Instituto Nacional de Cardiología "Ignacio Chávez," Mexico City, Mexico

Acute poststreptococcal GN (APSGN) is the prototype of immune complex GN and is associated with manifestations of autoimmune reactivity that have been neglected as epiphenomena. Recently, studies have demonstrated transient antifactor B autoantibodies that activate the alternative complement pathway, bringing self-immunity to a central position in the pathogenesis of APSGN. Therefore, examining other manifestations of autoimmunity that have been reported in association with poststreptococcal GN is of interest. Read More

Int J Mol Sci 2021 Jan 18;22(2). Epub 2021 Jan 18.

Hemodialysis Unit, Showanomori Hospital, Akishima, Tokyo 196-0024, Japan.

Acute glomerulonephritis (AGN) triggered by infection is still one of the major causes of acute kidney injury. During the previous two decades, there has been a major paradigm shift in the epidemiology of AGN. The incidence of poststreptococcal acute glomerulonephritis (PSAGN), which develops after the cure of group A infection in children has decreased, whereas adult AGN cases have been increasing, and those associated with nonstreptococcal infections, particularly infections by , are now as common as PSAGN. Read More

Mod Rheumatol Case Rep 2020 07 18;4(2):262-266. Epub 2020 Feb 18.

Faculty of Medicine and Graduate School of Medicine, Department of Pediatrics, Hokkaido University, Sapporo, Japan.

Although acute poststreptococcal glomerulonephritis (APSGN) and acute rheumatic fever (ARF) are well-known complications of group A streptococcus infection, concomitant occurrence of both diseases is rare. We report an 11-year-old Japanese girl with primary Sjögren's syndrome complicated by acute renal failure about 2 weeks after the onset of pharyngitis. Although histopathological findings of the kidney were not confirmative, APSGN was suggested by the spontaneous recovery of her renal function, typical latent period with high levels of antistreptolysin O and low serum levels of C3 but not of C4. Read More

Histopathology 2021 Mar 2;78(4):520-531. Epub 2020 Nov 2.

Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan.

Aims: Activated neutrophils release neutrophil extracellular traps (NETs), resulting in a form of cell death called NETosis. NET formation is reportedly involved in the onset of systemic lupus erythematosus and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Citrullination of histones is a key step in NET formation, and the presence of citrullinated histones in neutrophils may be associated with disease induction and activity. Read More

CEN Case Rep 2021 02 20;10(1):139-144. Epub 2020 Sep 20.

Department of Pediatrics, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.

The severity of the poststreptococcal acute glomerulonephritis is considered to be modulated by the immune response of each individual, although there had been few reports regarding specific factors. Renal cell carcinoma is a cancer frequently associated with paraneoplastic syndrome, characterized by fever, leukocytosis, elevated cytokines, and elevated hormone levels. All of these symptoms resolve after tumor resection. Read More

Sci Rep 2020 08 20;10(1):14026. Epub 2020 Aug 20.

Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.

Galactose-deficient IgA1 (Gd-IgA1) is important in the pathogenesis of IgA nephropathy (IgAN). A Gd-IgA1-specific monoclonal antibody (KM55) has revealed glomerular Gd-IgA1 deposition solely in patients with IgAN and IgA vasculitis with nephritis (IgAV-N). However, this specificity is controversial and has not been demonstrated in pediatric patients. Read More

CEN Case Rep 2020 11 26;9(4):418-422. Epub 2020 Jun 26.

Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo, Kobe, Hyogo, 650-0017, Japan.

Alport syndrome (AS) is a progressive kidney disease. Male cases with X-linked AS (XLAS) are reported to develop end-stage kidney disease (ESKD) at the age of around 20-30 years. One risk factor for developing ESKD at a young age is a genotype of having truncating variants in the COL4A5 gene. Read More

Int J Mol Sci 2020 Apr 8;21(7). Epub 2020 Apr 8.

Kidney Disease Center, Department of Nephrology and Blood Purification, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo 193-0998, Japan.

It is widely known that glomerulonephritis (GN) often develops after the curing of an infection, a typical example of which is GN in children following streptococcal infections (poststreptococcal acute glomerulonephritis; PSAGN). On the other hand, the term "infection-related glomerulonephritis (IRGN)" has recently been proposed, because infections are usually ongoing at the time of GN onset in adult patients, particularly in older patients with comorbidities. However, there has been no specific diagnostic biomarker for IRGN, and diagnosis is based on the collection of several clinical and pathological findings and the exclusion of differential diagnoses. Read More

IDCases 2020 15;19:e00659. Epub 2019 Oct 15.

Department of Pediatrics, Thriasio General Hospital, Athens, Greece.

Influenza virus primarily affects the respiratory system. It rarely causes extrapulmonary complications, with otitis media and febrile seizures being the most common in children. Acute glomerulonephritis as a complication of H1N1 influenza virus infection has been described only sporadically. Read More

Dtsch Med Wochenschr 2020 02 18;145(4):240-247. Epub 2020 Feb 18.

Glomerulonephritis, secondary to bacterial, or, more rarely, viral or parasitic infections, is called infection-associated. The epidemiology of infection-associated glomerulonephritis has changed in recent decades. For a long time, the classic form has been acute poststreptococcal glomerulonephritis (APGN), but in developed countries its incidence has declined sharply. Read More

BMC Nephrol 2019 12 18;20(1):471. Epub 2019 Dec 18.

Department of Nephrology and Dialysis, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480, Japan.

Background: Poststreptococcal acute glomerulonephritis (PSAGN) in the elderly tends to have a severe clinical course and often presents with crescentic necrotizing glomerulonephritis in the renal biopsy. However, vasculitis lesions are unusual.

Case Presentation: We present a 71-year-old man who was admitted to our hospital for a recurrent gout attack with a rapid decline of renal function. Read More

Pediatr Infect Dis J 2019 12;38(12):1183-1188

Heart Institute, Cincinnati Children's Hospital Medical Center.

Background: Group A Streptococcus (GAS) skin infections can lead to invasive sepsis, poststreptococcal glomerulonephritis, and potentially rheumatic heart disease (RHD). Within a study to identify predisposing factors of RHD in Ugandan schoolchildren, we determined the prevalence of skin infections and assessed the clinical features and antibiotic susceptibility of GAS skin infection.

Methods: Cross-sectional study conducted at 3 urban primary schools in Western and Northern Uganda in March 2017. Read More

Clin Nephrol 2019 Nov;92(5):263-272

Infection-related glomerulonephritis (IRGN) was previously thought to be due mostly to species, but is now known to be caused by a variety of other pathogens. Nephritis-associated plasmin receptor (NAPlr) was originally isolated from group A streptococci as the protein responsible for acute poststreptococcal glomerulonephritis, and was shown to be identical to streptococcal glyceraldehyde-3-phosphate dehydrogenase (GAPDH). Here, we describe a 7-year-old boy diagnosed with IRGN presenting with acute nephritic syndrome. Read More

Curr Rheumatol Rev 2020 ;16(1):2-8

Department of Rheumatology, Queen's University, Kingston, ON, Canada.

Introduction: Post-Streptococcal Reactive Arthritis (PSRA) is defined as inflammatory arthritis of ≥1 joint associated with a recent group A streptococcal infection in a patient who does not fulfill the Jones criteria for the diagnosis of Acute Rheumatic Fever (ARF).

Methods: In this narrative review, we conducted a systematic search on MEDLINE, EMBASE, Cochrane Library and Google Scholar using the words poststreptococcal reactive arthritis. The search covered the time period between 1982 and 2016. Read More

Clin Rev Allergy Immunol 2019 Oct;57(2):294-302

Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Streptococcus A infections have been associated with immune-mediated sequelae including acute glomerulonephritis, acute rheumatic fever, thrombocytopenia, hemolytic anemia, Henoch-Schönlein purpura, arthritis, uveitis, guttate psoriasis, and erythema nodosum. Available reviews do not report the occurrence of acute poststreptococcal glomerulonephritis in association with one of the mentioned conditions. We performed a systematic review of the literature on extrarenal immune-mediated disorders associated with acute poststreptococcal glomerulonephritis. Read More

J Am Acad Dermatol 2020 Mar 13;82(3):533-548. Epub 2019 Jul 13.

Department of Dermatology, University of California, San Francisco, San Francisco, California; International Alliance for the Control of Scabies, Parkville, Australia. Electronic address:

Scabies is an ectoparasitic dermatosis caused by Sarcoptes scabiei var. hominis and is a public health issue in all countries regardless of socioeconomic status. In high-income countries, delays in diagnosis can lead to institutional outbreaks; in low- and middle-income countries, poor access to health care contributes to disease undertreatment and long-term systemic sequelae. Read More

Front Pediatr 2019 21;7:202. Epub 2019 May 21.

Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

Kawasaki disease (KD) may be associated with infection of unknown pathogen(s). For predicting of the etiology of KD, we evaluated epidemiological characteristics in KD, common infectious diseases and immune-mediated diseases in childhood. We respectively, reviewed the data of patients with KD, influenza, aseptic meningitis, exanthem subitum (ES), (MP) pneumonia, acute pyelonephritis (APN), Henoch-Schönlein purpura (HSP), acute poststreptococcal glomerulonephritis (APSGN), and childhood asthma. Read More

Open Forum Infect Dis 2019 Apr 26;6(4):ofz097. Epub 2019 Feb 26.

Menzies School of Health Research, Charles Darwin University.

Background: In high-burden settings, guidelines recommend antibiotic treatment for all suspected group A (GAS) infections to prevent rheumatic fever and poststreptococcal glomerulonephritis. Highly sensitive rapid GAS tests could reduce unnecessary antibiotic use in these settings.

Methods: This was a prospective study of the Xpert Xpress Strep A (Cepheid) molecular test compared with culture of throat swab samples collected at a referral hospital in northern Australia. Read More

Microbiol Spectr 2019 03;7(2)

University of Miami Miller School of Medicine and Miami Veterans Affairs Healthcare System, Miami, FL 33125.

Streptococci carrying serogroup C and G antigens, and in particular, subsp. (SDSE), are emerging human pathogens that are increasingly isolated from patients with a myriad of infections that range from mundane to life-threatening. SDSE is microbiologically similar to . Read More