than normal population.2Sporadic disease is common
but epidemic outbreaks tend to occur in closed
populations and in less developed countries.6,7
M protein contributes to virulence and glomerular
injury.Streptokinase involved in spread of bacterium
through tissue.2Two antigens are actively investigated
at the present time as the potential causes of APSGN:
the nephritis associated plasmin receptor
(NAPlR),identified as glyceraldehydes 3 phosphate
dehydrogenase and a cationic cysteine proteinase
known as streptococcal pyrogenic exotoxin B(SPEB)
are capable of activating the alternate pathway of
complement activation.8
Molecular mimicry between streptococcal antigens
and glomerular antigens that react with antibodies
against streotococcal antigens and direct activation
of complement cascade by both classical and alternate
pathways occur.1 Infiltration of neutrophil, proliferation
of glomerular cells, mesengial cell and expansion of
mesengial matrix take place(type iii immune complex
reaction)1,glomeruli are diffusely enlarged and lobular
pattern is accentuated.1,8