Hi, this is Tom, and in this episode I'm going to be going through nephritis in children.

And you can find notes at zero to finals.com and in the zero to finals pediatrics book.

And you can find flashcards and questions to train your knowledge at members.com.com.

And at the end of the episode, we'll go through some questions so you can test yourself on what

you just heard. So let's jump straight in. Nephritis refers to inflammation in the nephrons

of the kidneys.

It causes reduced kidney function, hematuria, which is blood in the urine, and protein urea, which is protein in the urine.

The two most common causes of nephritis in children are post-streptoccal glomerula nephritis and IGA nephropathy,

or Berger's disease. Let's start by talking about post-streptoccal glomerula nephritis.

Post-streptoccal glomerilinephritis occurs one to three weeks

following an infection with Group A Streptococcus, for example tonsillitis caused by streptocococcus pyogens.

Immune complexes made of streptococcal antigens, antibodies and complement proteins get stuck in the glomeruli, causing inflammation and leading to an acute drop in renal function or acute kidney injury.

The typical patient is aged 5 to 12 years, has a history of tonsillitis and presents with edema,

hematuria, or blood in the urine, and high blood pressure.

Management is supportive. Most patients make a full recovery. Rarely it can cause

chronic kidney disease. Complications such as hypertension and edema may be treated with

anti-hypertensive drugs and diuretics.

Next let's talk about IGA nephropathy.

IGA nephropathy, also known as Berger's disease, involves immunoglobulin A deposits in the nephrons

of the kidneys, causing inflammation or nephritis.

Histology from a renal biopsy shows IGA deposits and mesangial proliferation.

The mesangial cells are found in the center of the glomerulus and they help to

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