An 11 year old boy living in isolated village was experiencing drastic weight ga

Question

An 11 year old boy living in isolated village was experiencing drastic weight gain, with abdominal distension, in a period of 16 days. He complained of feeling weak, lethargic and his "belly" was bothering him. His mother noticed traces of blood in urine. Medical history was significant for a recent episode of a cold and sore throat that were self limiting conditions. Physical exam revealed generalized edema, along with swelling of the abdomen and genitalia. A serum antistreptolysin o antibody was positive with a significant degree of hypoalbuminemia. Urinalysis demonstrated proteinuria (2.5 gr/day) and traces of blood (hematuria), as well some hemoglobin casts in the urine (hemoglobinuria). This patient was hospitalized and placed on a tapering prednisone therapy. What is the significance of the antistreptolysin o antibody finding?

Explanation / Answer

The boy is showing signs of renal involvement and failure. The positive serum antistreptolysin O antibody reveals that he has had a recent streptococcal infection, which then can cause a post-infectious glomerulonephritis. Glomerulonephritis is a type of kidney disease in which the part of your kidneys that helps filter waste and fluids from the blood is damaged. Proteinuria and blood on urinalysis supports this diagnosis. For treatment, prednisone is initiated to reduce inflammation in the kidneys, as a supportive therapy to reduce symptoms until the disease resolves itself. Usually within 2 to 4 weeks.

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