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Article: Eosinophilic glomerulonephritis in children in Southwestern Uganda

TitleEosinophilic glomerulonephritis in children in Southwestern Uganda
Authors
Issue Date2007
Citation
Kidney International, 2007, v. 71 n. 6, p. 569-573 How to Cite?
AbstractAcute renal disease is common in sub-Saharan Africa, with high mortality. Its etiology is poorly understood; quartan malaria owing to Plasmodium malariae was implicated in previous series. Few previous studies have included histological data; furthermore, much of the literature pre-dates the human immunodeficiency virus (HIV) epidemic. We report prospective analysis of acute proteinuric renal disease in children in rural Uganda. Clinical and laboratory data are presented on 65 patients (aged 2-14 years, mean 8.4; 35 male, 30 female) in 41 of whom histological diagnosis was obtained by renal biopsy. The most frequent histological finding was endocapillary proliferative glomerulonephritis (GN) in 27/41 cases, in 20 of which eosinophils were very prominent. No cases showed features of HIV nephropathy. Malarial films were positive in 11 cases: all owing to Plasmodium falciparum. Patients were treated with diuretics, antihypertensives, and supportive measures. Corticosteroids were rarely used, being reserved for patients with minimal changes on renal biopsy. Clinical outcomes were fair: 91% of patients survived to discharge. We conclude that acute GN is common in children in Uganda, that an unusual eosinophilic proliferative GN is the most frequent histological finding, that HIV is not implicated as an important factor in this age group, and that good outcomes can be achieved using simple clinical and laboratory diagnostic methods. Renal biopsy in selected cases is feasible and helpful, especially in allowing rational use of corticosteroids and other potentially toxic treatments. Symptomatic treatments and careful supportive care will allow the majority of children to recover. © 2007 International Society of Nephrology.
Persistent Identifierhttp://hdl.handle.net/10722/195443
ISSN
2015 Impact Factor: 7.683
2015 SCImago Journal Rankings: 3.181
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWalker, A-
dc.contributor.authorEllis, J-
dc.contributor.authorIrama, M-
dc.contributor.authorSenkungu, J-
dc.contributor.authorNansera, D-
dc.contributor.authorAxton, J-
dc.contributor.authorCoward, RJ-
dc.contributor.authorPeat, DS-
dc.contributor.authorBode, HH-
dc.contributor.authorMathieson, PW-
dc.date.accessioned2014-02-28T06:12:09Z-
dc.date.available2014-02-28T06:12:09Z-
dc.date.issued2007-
dc.identifier.citationKidney International, 2007, v. 71 n. 6, p. 569-573-
dc.identifier.issn0085-2538-
dc.identifier.urihttp://hdl.handle.net/10722/195443-
dc.description.abstractAcute renal disease is common in sub-Saharan Africa, with high mortality. Its etiology is poorly understood; quartan malaria owing to Plasmodium malariae was implicated in previous series. Few previous studies have included histological data; furthermore, much of the literature pre-dates the human immunodeficiency virus (HIV) epidemic. We report prospective analysis of acute proteinuric renal disease in children in rural Uganda. Clinical and laboratory data are presented on 65 patients (aged 2-14 years, mean 8.4; 35 male, 30 female) in 41 of whom histological diagnosis was obtained by renal biopsy. The most frequent histological finding was endocapillary proliferative glomerulonephritis (GN) in 27/41 cases, in 20 of which eosinophils were very prominent. No cases showed features of HIV nephropathy. Malarial films were positive in 11 cases: all owing to Plasmodium falciparum. Patients were treated with diuretics, antihypertensives, and supportive measures. Corticosteroids were rarely used, being reserved for patients with minimal changes on renal biopsy. Clinical outcomes were fair: 91% of patients survived to discharge. We conclude that acute GN is common in children in Uganda, that an unusual eosinophilic proliferative GN is the most frequent histological finding, that HIV is not implicated as an important factor in this age group, and that good outcomes can be achieved using simple clinical and laboratory diagnostic methods. Renal biopsy in selected cases is feasible and helpful, especially in allowing rational use of corticosteroids and other potentially toxic treatments. Symptomatic treatments and careful supportive care will allow the majority of children to recover. © 2007 International Society of Nephrology.-
dc.languageeng-
dc.relation.ispartofKidney International-
dc.titleEosinophilic glomerulonephritis in children in Southwestern Uganda-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1038/sj.ki.5002085-
dc.identifier.pmid17228362-
dc.identifier.scopuseid_2-s2.0-33947123806-
dc.identifier.volume71-
dc.identifier.issue6-
dc.identifier.spage569-
dc.identifier.epage573-
dc.identifier.isiWOS:000244748900016-

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