Case presentation
A 10-year-old boy was referred to our clinic complaining of severe constipation, oliguria, and edema. He had previously undergone evaluations and had a raised serum creatinine level. He also had a history of visiting a crowded area and later experiencing fever and other flu-like symptoms. The symptoms were treated with conservative treatment. In his past medical history, he had been completely healthy, had no medical or familial disorders, and had completed his series of vaccinations.
He was referred to our clinic with peri-orbital edema, congestion during a chest exam, hypertension, and anuria. His parents also reported that he had normal urination in the previous two days before a sudden onset of low-volume urination. He was given Lasix with normal saline, but he did not respond to this treatment, and laboratory tests revealed elevated creatinine levels. Table 1 . Large kidneys were seen during an abdominal ultrasound study, and as a result of his high creatinine level, anuria, and lack of response to Lasix therapy, the patient underwent sessions of emergent dialysis.
On the second day of hospitalization, the patient started experiencing severe low back pain, which persisted throughout dialysis. Considering the laboratory results and the requirement for daily dialysis, a kidney biopsy was performed to confirm PSGN(Figure 1) ; however, the biopsy report revealed PSGN without crescentic features. The patient had a seizure on the third day of his hospital stay, which was managed with phenytoin and carbamazepine. He also received rasburicase for hyperuricemia, adjusted doses of ciprofloxacin, meropenem, and cefazoline, as well as five doses of methylprednisolone for the treatment of PSGN. Following the methylprednisolone prescription, the patient’s symptoms improved noticeably, and PSGN therapy was used to treat the patient’s back pain and constipation.
The patient was given a clean bill of health and was referred for follow-up exams. At the most recent checkup, his kidney size and creatinine level were both within normal ranges.