Coexistence of acute post-streptococcal glomerulonephritis and acute rheumatic fever: case report and systematic review.
Tolga Kasap, Ahmet İrdem, Selçuk Yüksel
✦ AI-curated · Sources linked
Case in brief
A 15-year-old boy developed ankle pain and eyelid and limb edema after a throat infection. Investigations showed nephritic syndrome and elevated antistreptolysin O levels; echocardiography demonstrated rheumatic carditis with multivalve involvement. He was diagnosed with concurrent acute post-streptococcal glomerulonephritis and acute rheumatic fever and received benzathine penicillin, oral prednisolone, furosemide, and antihypertensive therapy. Kidney parameters returned to normal during follow-up, but mild valvular regurgitation persisted.
What made this case unusual
The case combined two post-streptococcal complications traditionally associated with distinct streptococcal strains and different immunopathogenesis: glomerulonephritis and rheumatic carditis.
Diagnostic / clinical pearl
In a patient with post-streptococcal nephritic findings, consider concurrent rheumatic carditis when clinical, electrocardiographic, or systemic features raise suspicion; echocardiography can identify cardiac involvement.
Why it matters
In the reviewed cases, kidney recovery was reported in 26/27 patients with follow-up, while persistent cardiac sequelae were reported in 19/27, underscoring the importance of cardiac follow-up after nephritic manifestations resolve.