Persistent hypocomplementemia in a 9 year old boy following acute post-streptococcal glomerulonephritis

Acute post-streptococcal glomerulonephritis (APSGN) is a common form of acute glomerulonephritis in children [1]. It is presented with edema, hematuria, acute renal failure and hypertension and hypocomplementemia 7-10days following agroup a -hemolytic streptococcal pharyngitis or 2-4 weeks following an impetigo [2-4]. Subclinical forms are common in close contacts [5-7]. APSGN usually is a self-limiting disease and only requires conservative therapy for complications of acute kidney injury and also management of hypertension. Severe cases may occur with a rapidly progressive course (rapidly progressive glomerulonephritis RPGN) [8], which may need kidney biopsy and pulse therapy with corticosteroids. Alternate pathway activation and depression of C3 is the usual mechanism but in some cases there may be activation of classic pathway [4]. C3 Complement returns to normal level within 8 weeks. In our case despite a usual feature APSGN and spontaneous resolution of nephritis C3 is still low even after 5.5 years.