Ref Number = PITIKA-ASPR0270
Bella Kurnia, Elien Yuwono, I Wayan Bikin Suryawan
BACKGROUND: Acute glomerulonephritis is an acute immunological reacion of the kidney toward bacteria with characteristic of glomerular damage with abrupt onset. In children, the most common cause of acute glomerulonephritis is  group A beta hemolyticus streptococus infection.1 In Indonesia, there are observational study for children with acute poststreptococcal glomerulonephritis (APSGN) in 11 university on 1997-2002, with >80% of the children experience pleural effusion, cardiomegali with pericardial effusion, and 9,2% with hypertensive encephalopathy.2 
OBJECTIVE: This case is aimed to study hypertensive encephalopathy as a complication in child with APSGN.
CASE: A 14 year old boy admitted to the hospital with chief complain of  seizure few minutes before admission. One day before admission, he experience severe headache and vomitting (>6 times). Approximately one week before admission, he experience upper respiratory tract infection characterized by cough and flu. He also complaint of blurred vision. The boy had second tonic seizure when in the ER and third seizure in the pediatric ward about 20 minutes before arriving at PICU without return of consciusness. From physical examination, the blood pressure is 160/120 mmHg and  from the laboratory findings, there are a slight increasing leucocyte, from urinalysis findings: mild proteinuria (+1), microhematuria, erithrocytes in the urine and a normal CT scan. The patient was admitted to the PICU and given treatment with cefotaxime 3x1 gr, ranitidine 2x50 mg, Furosemide 2x20 mg, Phenytoin loading dose 1000 mg followed by 2x120 mg (maintainance), captopril 2x 6,25 mg, and intravenous dexamethasone 3x5mg. From the above findings, the patient was diagnosed with hypertensive encephalopathy cause by APSGN and discharged from the hospital after 5 days.
CONCLUSION: In this case the child has the classical symptom of APSGN with severe hypertension that leads to encephalopathy as the complication. The mejority of children will recover spontaneously over 2-3 weeks with resolution of all abnormal symptoms.
Keywords: APSGN, acute poststreptococcal glomerulonephritis, case, pediatrics, hypertensive encephalopathy
Disclaimer: The Views and opinions expressed in the articles are of the authors and not of the journal.
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