POST-STREPTOCOCCAL GLOMERULONEPHRITIS: HISTOPATHOLOGIC AND CLINICAL STUDIES OF THE ACUTE, SUBSIDING ACUTE AND EARLY CHRONIC LATENT PHASES*†

Abstract

The histopathologic findings and clinical course of 36 patients with post-streptococcal acute glomerulonephritis are reported. All patients were first biopsied within 6 months of onset and have been followed until they healed clinically or developed clinical chronic glomerulonephritis; 56 percutaneous biopsies were obtained. The 36 patients exhibited much of the spectrum of the renal response to a nephritogenic streptococcal infection. Included are 7 patients whose disease was so mild that the diagnosis rested primarily on laboratory findings and 29 who had overt clinical disease of slight to marked severity. One patient died while anuric 32 days after onset. Distinctive renal lesions were observed in the glomeruli of 32 patients; 26 showed mild, moderate or marked diffuse proliferative glomerulonephritis, while 6 showed diffuse exudative glomerulonephritis. The glomeruli of the remaining 4 patients showed no distinctive lesions: They have been classified as presumed focal glomerulonephritis; 1 of the 4 had a subacute interstitial inflammatory reaction. The nephritis had not healed at the last follow-up in 13 patients. In general, those patients had more lobular stalk hyper-cellularity and evidences of glomerular damage than did those patients who achieved clinical healing. The relationship of the glomerular lesions observed to the severity of the clinical disease and to the patho-genesis of chronic glomerulonephritis is discussed.