Rapidly progressive glomerulonephritis in black children. A report of 4 cases

Rapidly progressive glomerulonephritis in children in rare, and we have therefore described 4 cases in Black children. All had evidence of a preceding streptococcal infection and there were crescents in more than 80% of the glomeruli seen on histological examination. The dominant clinical features were oliguria or anuria in a setting of nephritis or nephrotic syndrome, with a relentless progression to chronic renal failure and death. Quadruple therapy with cyclophosphamide, steroids, heparin and dipyridamole in 3 of the patients was of no lasting benefit and was attended by severe complications. Guidelines to the monitoring of children with post-streptococcal glomerulonephritis for the early detection of this uncommon complication are given.