Сoordination with the pediatrician: Acute post-streptococcal glomerulonephritis

Abstract

The increased cases of Group A β-haemolytic Streptococci (GAS) infection in Europe since 2022 has actualized the issue of diagnosis and treatment of Acute Post-Streptococcal Glomerulonephritis (APSGN), which remains the most frequent immune complex kidney pathology in children. The specificity of modern Ukraine due to active hostilities, the uncertainty of the epidemiological situation, and the absence of valid national protocols complicate the process of making a clinical decision at the local level. The present review aims to highlight the diagnostic evaluation, clinical course, and management of APSGN in children to improve disease outcomes under martial law in the country. The main GAS characteristics, laboratory evidence of preceding infection and their interpretations, and variants of the APSGN course based on the analysis of actual international guidelines, recommendations, and reference center protocols are presented. The treatment management experience of this cohort is summarized with attention to the limited approach to antibacterial agents. The differences in Ukrainian practice, which were formed by past regiments and are still present in the local centers of the country, are emphasized. A typical disease resolve order and features that require diagnosis revision and tactical changes are given. From the standpoint of acquired evidence, the surveillance of several clinical cases is presented and re-evaluated.