Acute non-proliferative glomerulitis: a cause of renal failure unique to children

Pediatr Nephrol. 2000 Aug;14(8-9):786-93. doi: 10.1007/pl00024626.

Abstract

Over a 31-year period, we have encountered 13 children with a disease entity not reported by other clinics that leads to rapidly progressive crescentic glomerulonephritis. Gross hematuria, rapidly declining renal function, and a serum C3 level at the lower limit of normal or slightly depressed usually characterized the disease onset; hypertension and nephrotic syndrome were absent. Glomerular IgG was absent, but large C3-containing subepithelial deposits on the paramesangial basement membrane (GBM) were always present. Because of these deposits and because dense alteration of the GBM was found in 3 patients, the disease may resemble membranoproliferative glomerulonephritis type II, but is distinguishable on other morphological and clinical grounds. The absence of anti-neutrophil cytoplasmic antibody, tested for in 5 of 13 patients, is one of several ways the disease differs from the pauci-immune glomerulonephritis of adults. Clinically and by glomerular morphology, it also differs from severe poststreptococcal acute glomerulonephritis. Treatment with high-dose corticosteroids has been highly successful. Because in this series the disease occurred only in children under age 12 years and the amount of silver-positive mesangial matrix was normal, indicating absence of mesangial proliferation, it has been designated juvenile acute non-proliferative glomerulitis.

MeSH terms

  • Acute Disease
  • Biopsy
  • Child
  • Child, Preschool
  • Creatinine / blood
  • Disease Progression
  • Glomerulonephritis / complications*
  • Glomerulonephritis / diagnosis*
  • Glomerulonephritis / physiopathology
  • Hematuria
  • Humans
  • Kidney / pathology
  • Kidney / ultrastructure
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / etiology*
  • Kidney Failure, Chronic / physiopathology
  • Recurrence
  • Remission, Spontaneous
  • Retrospective Studies

Substances

  • Creatinine