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.