Publication:
A progressive ANCA associated glomerulonephritis leading to chronic kidney disease and stroke in a child with congenital heart disease: a case report

dc.contributor.authorJha, Ashish
dc.contributor.authorShah, Shiv Kumar
dc.contributor.authorThakur, Baidyanath
dc.contributor.authorMandal, Abhay
dc.contributor.authorThakur, Jitendra
dc.date.accessioned2025-08-17T10:40:58Z
dc.date.available2025-08-17T10:40:58Z
dc.date.issued2025
dc.descriptionA progressive ANCA associated glomerulonephritis leading to chronic kidney disease and stroke in a child with congenital heart disease: a case report Ashish Jha1,*, Shiv Kumar Shah1, Baidyanath Thakur1, Abhay Mandal1, Jitendra Thakur1
dc.description.abstractABSTRACT Nephrotic-nephritic syndrome in children is a rare but significant cause of chronic kidney disease (CKD). This case highlights a challenging diagnostic and therapeutic course involving persistent hematuria, ANCA positiv- ity, refractory hypertension, and cerebrovascular complications. A 10-year-old female, post-patent ductus ar- teriosus (PDA) closure, presented with generalized swelling, hematuria, and proteinuria. Initial workup sug- gested post-infectious glomerulonephritis (PIGN) with persistently low complement levels (C3, C4), and she was managed with diuretics. However, recurrent episodes led to further evaluation, revealing PR3-ANCA positivity, nephrotic-range proteinuria, and progressive renal dysfunction. Despite treatment, she developed refractory hypertension and an intracranial hemorrhage. The absence of renal biopsy posed challenges in definitive diag- nosis, and the patient is now on dialysis. This case underscores the diagnostic challenges in differentiating between PIGN, ANCA-associated glomerulo- nephritis, and rapidly progressive glomerulonephritis (RPGN) in pediatric patients. The interplay between con- genital heart disease and renal dysfunction highlights the need for interdisciplinary management. Early biopsy in recurrent nephrotic-nephritic cases is crucial to prevent irreversible renal damage. The case emphasizes the need for early renal biopsy and comprehensive management of pediatric nephrotic-nephritic syndrome with persistent proteinuria and hematuria.
dc.identifier.urihttps://hdl.handle.net/20.500.14572/1702
dc.language.isoen_US
dc.publisherMadhesh Institute of Health Sciences (MIHS)
dc.titleA progressive ANCA associated glomerulonephritis leading to chronic kidney disease and stroke in a child with congenital heart disease: a case report
dc.typeArticle
dspace.entity.typePublication
local.article.typeCase Report
oaire.citation.endPage41
oaire.citation.startPage39
relation.isJournalIssueOfPublication6a3709b0-91e5-4b0f-8c02-92658e57e4dc
relation.isJournalIssueOfPublication.latestForDiscovery6a3709b0-91e5-4b0f-8c02-92658e57e4dc
relation.isJournalOfPublicationd4600a08-1f72-4625-8a43-fa818d03ff5b

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