Coexistence of acute post-streptococcal glomerulonephritis and acute rheumatic fever: case report and systematic review - PubMed

6 days ago

Acute rheumatic fever (ARF) and acute poststreptococcal glomerulonephritis (APSGN) are rare but serious complications of group A β-hemolytic streptococcal infections.
A 15-year-old male patient presented with concurrent APSGN and ARF, showing symptoms like ankle pain, edema, and elevated ASO levels, with echocardiography revealing rheumatic carditis.
Treatment included benzathine penicillin, prednisolone, furosemide, and antihypertensive therapy, leading to kidney recovery but persistent mild valvular regurgitation.
A systematic review of 36 cases found that 86.1% were pediatric, with common symptoms being edema (63.8%), fever (55.5%), and hypertension (55.5%).
Mitral regurgitation was the most frequent cardiac finding (88.8%), and corticosteroids were used in 44.4% of cases.
Kidney recovery was reported in 96.2% of cases, while 70.3% had persistent cardiac sequelae, mainly mitral regurgitation (59.2%).
The study emphasizes the need for a multidisciplinary approach, long-term cardiac surveillance, and secondary prevention in patients with APSGN and ARF.

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