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Pediatría (Asunción)

versión On-line ISSN 1683-9803

Resumen

TROCHE, Avelina et al. Frequency and characteristics of hypertensive encephalopathy secondary to postinfectious glomerulonephritis in patients admitted to a national reference hospital. Pediatr. (Asunción) [online]. 2023, vol.50, n.1, pp.33-39.  Epub 11-Abr-2023. ISSN 1683-9803.  https://doi.org/10.31698/ped.50012023007.

Introduction:

Acute post-infectious glomerulonephritis (APGN) can present with complications such as hypertensive encephalopathy in 7-11% of cases.

Objective:

to determine the frequency and characteristics of hypertensive encephalopathy (HE) secondary to APGN in patients admitted to the Department of Pediatrics of the National Hospital from January/2000 to December/2018.

Materials and Methods:

This was an observational, descriptive and retrospective study of patients with nephritic syndrome (NS) with decreased C3 and normalization at three months, with severe arterial hypertension (AHT) accompanied by neurological manifestations (headache, nausea, vomiting, altered consciousness, seizures), which subsided when the AHT was controlled. Sociodemographic (age, sex, place of residence, parental education level, number of children in home) and clinical (peripheral edema, acute pulmonary edema, hematuria, and neurological manifestations) characteristics were studied. The data were analyzed using descriptive statistics through EPI INFO (CDC, Atlanta), expressing the quantitative variables as median and interquartile range (IQR) and the qualitative ones as absolute frequency and percentage.

Results:

27/160 (16.8%) patients developed HE. Age ranged from 3 to 16 years (median: 10 years; IQR: 5); the most frequent infectious history was pyodermitis (40.7%), followed by acute pharyngitis (37%). All patients presented peripheral edema and severe headache. The duration of AHT had a median of 5 days (IQR: 4) and the days of hospitalization a median of 7 (IQR: 6). No patient required dialysis or was left with sequelae, no deaths were recorded.

Conclusion:

in patients with HE, the diagnosis of APGN should be considered, a history of infections obtained and adequately assessing fluid status.

Palabras clave : Hypertensive encephalopathy; nephritic syndrome; children.

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