What are the signs and symptoms of acute poststreptococcal glomerulonephritis (APSGN)?

Updated: Dec 05, 2018
  • Author: Rajendra Bhimma, MBChB, MD, PhD, DCH (SA), FCP(Paeds)(SA), MMed(Natal); Chief Editor: Craig B Langman, MD  more...
  • Print

The classic triad of gross hematuria, edema, and hypertension are the most common presenting symptoms.  However, some patients may have a subclinical presentation with microscopic hematuria, minimal or no edema, and normal or just mildly elevated blood pressure.  Hematuria is almost a universal finding with about one third of patients having gross hematuria. The dark urine is due to the oxidation of hemoglobin that turns brown after a prolonged time in an acidic environment.  Gross hematuria may last up to 10 days and recur after a febrile illness. Edema occurs in about 65 -90% of patients and ascites is typically absent. Edema tends to last between 7-10 days.  Pulmonary edema is uncommon except in the very severe cases.  Hypertension occurs in about 60-80% of cases, present in the acute phase of the disease and is usually transient, lasting about 10 days. Hypertensive encephalopathy has been reported in about 11% of patients untreated in developing countries. Scanty urine or oliguria is seen in less than 50% of patients.  Nonspecific symptoms included malaise, weakness, nausea and dull flank pain. 

Recent poststreptococcal infection is most commonly demonstrated by serologic markers for elevated antibodies to extracellular streptococcal antigens.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!