Risk factors and outcome of atypical acute post-streptococcal glomerulonephritis in pediatrics.

We conducted this study to identify the clinical features and risk factors for atypical acute post-streptococcal glomerulonephritis (APSGN). Thirty-five cases of atypical APSGN treated at Srinagarind Hospital during 2002-2009 were compared with 27 typical cases. The clinical symptoms, anti-streptococcal antibody titers, and laboratory data at the first hospital visit were compared between the two groups. A marked elevation in anti-streptolysin O (ASO) titer was seen more commonly in the atypical APSGN group than in the typical APSGN group (p=0.025). Significantly more patients in the atypical APSGN group had a high urine specific gravity, hematuria and pyuria than patients in the typical APSGN group (p<0.01, p<0.031, and p<0.046, respectively). A high ASO titer, high urine specific gravity, severe hematuria and pyuria early in the illness were suggestive of a higher risk for an atypical presentation.