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  • Title: Delay in diagnosis in poststreptococcal glomerulonephritis.
    Author: Pais PJ, Kump T, Greenbaum LA.
    Journal: J Pediatr; 2008 Oct; 153(4):560-4. PubMed ID: 18534213.
    Abstract:
    OBJECTIVE: To determine the frequency and risk factors for diagnostic delays in children with poststreptococcal glomerulonephritis (PSGN). STUDY DESIGN: We reviewed the charts of 52 children with PSGN, and identified children with a delay in diagnosis of more than 24 hours. We determined risk factors for delay in diagnosis using univariate and multivariate logistic regression. RESULTS: 17 children (33%) with PSGN had a delay in diagnosis. Delay in diagnosis occurred in 14% of children with gross hematuria as a presenting complaint and in 54% of children without gross hematuria as a presenting complaint (3.8 increased relative risk, 95% CI = 1.4 to 10; P = .02). A delay in diagnosis was more common in children with a negative infection history (P = .04). In multiple logistic regression, only the absence of gross hematuria as a presenting complaint was associated with a delay in diagnosis (P = .01). All children with a delay in diagnosis had microscopic hematuria on their initial urinalysis. CONCLUSIONS: Delay in diagnosis is common in children with PSGN, especially if visible hematuria is not a presenting complaint. Physicians should consider the possibility of PSGN in children with symptoms that may be secondary to volume overload. A urinalysis is a helpful initial diagnostic test.
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