Arslansoyu Çamlar S.Soylu A.Akil İ.Ünlü M.Coşkun Ş.Ertan P.Kavukçu S.2024-07-222024-07-22201820469047http://akademikarsiv.cbu.edu.tr:4000/handle/123456789/15028Besides association with acute rheumatic fever (ARF) and acute glomerulonephritis (APSGN), in up to 40% of cases, Group A β-haemolytic streptococcal (GABHS) infections are also implicated as a trigger for Henoch–Schonlein purpura (HSP). A 7-year-old girl with GABHS throat infection who developed HSP, APSGN and rheumatic carditis is reported. She presented with palpable purpura and arthritis in both ankles and later developed carditis characterised by mitral/aortic regurgitation and glomerulonephritis characterised by mixed nephritic/nephrotic syndrome. She had a raised anti-streptolysin titre (ASOT), blood urea nitrogen and creatinine and hypocomplementaemia (C3), and renal biopsy demonstrated endocapillary and extracapillary proliferative glomerulonephritis with crescents. Immunofluorescence microscopy demonstrated a ‘full house’ of immunoglobulin and complement, viz. IgA + 2, IgG + 3, IgM + 2, C3c + 1, Clq + 2 with predominantly IgG deposition. One week earlier, her 4-year-old sister had presented to another hospital with HSP complicated by microscopic haematuria, nephrotic-range proteinuria and gastro-intestinal involvement, and with raised ASOT and low C3 levels. Although HSP has been associated with either ARF or APSGN, this is the first case of a child with HSP, ARF and APSGN in combination. © 2017 Informa UK Limited, trading as Taylor & Francis Group.EnglishAntistreptolysinBiopsyChildComplement System ProteinsCreatinineFemaleGlomerulonephritisHistocytochemistryHumansImmunohistochemistryKidneyMicroscopyMicroscopy, FluorescencePurpura, Schoenlein-HenochRheumatic Heart DiseaseStreptococcal InfectionsUreaacetylsalicylic acidalbuminantistreptolysinC reactive proteincomplement component C1qcomplement component C3complement component C3ccomplement component C4creatinineenalaprilfurosemidehemoglobinimmunoglobulin Aimmunoglobulin Gimmunoglobulin Mmethylprednisolonepenicillin derivativeprednisoloneantistreptolysincomplementcreatinineureaacute rheumatic carditisallergic glomerulonephritisanaphylactoid purpuraaortic regurgitationArticleascitesbacterium cultureblood culturebody temperaturecarditiscase reportcentral venous pressurechildclinical articlediastolic heart murmurdisease associationdisease severityechocardiographyedemaerythrocyte sedimentation ratefemalegroup A streptococcal infectionhematuriahumanhypertensionimmunofluorescence microscopykidney biopsyleukocyte countlung auscultationmitral valve regurgitationoccult bloodonset agepercussionplatelet countpleura effusionproliferative glomerulonephritisprotein urine levelproteinuriapulse ratepurpuric rashschool childsymptomsystolic heart murmurtachypneathorax radiographyurea nitrogen blood levelurine sedimentanaphylactoid purpurabiopsybloodcomplicationcytochemistryfluorescence microscopyglomerulonephritisimmunohistochemistrykidneymicroscopypathologyrheumatic heart diseaseStreptococcus infectionArticle10.1080/20469047.2017.1284394