Pediatric Nephrology

Pediatr Nephml (1992) 6:231 - 235 9 IPNA 1992

Original article Crescentic glomerulonephritis in children Helena M. P. F. Jardiml, Janet Leake 2, R. Anthony Risdon 2, T. Martin Barratt 1, and Michael J. Dillon 1 1Renal Unit and 2 Departmentof Histopathology,Hospitalfor Sick Children, Great Ormond Street,LondonWC1N 3JH, UK ReceivedJune 13, 1991;receivedin revised form November26, 1991; acceptedDecember3, 1991

Abstract. Data on patients with crescentic glomerulonephritis (>50% glomeruli with crescents), referred to the Hospital for Sick Children during the past 13 years, were reviewed. Thirty patients (13 male, 17 female) aged 3.7-15.7 years (mean 9.5) were evaluated. Initial clinical features included: oedema (24/30), hypertension (19/30), gross haematuria (15/30), oliguria (15/30) and a decreased glomemlar filtration rate (GFR 80% crescents) 11 6.6 M 12 9.3 F 13 8.0 M 14 11.8 M 15 10.6 F 16 8.5 M 17 10.7 F 18 7.4 F 19 9.5 M 20 11.2 M 21 10.8 F 22 12.3 F 23 11.6 F 24 11.9 M 25 6.5 F 26 7.2 F 27 9.8 F 28 9.7 M 29 11.4 F 30 3.7 M

13i I I I I

HSP HSP HSP HSP HSP HSP GBM GBM PAN Mic Pol Mic Pol Mic Pol Wegener's Idiopathic Idiopathic Idiopathic Idiopathic MCGN I MCGN I PSGN

% Fibrous PD crescents crescents

50 50 60 60 70 50 50 55 70 75

+ + . + -

85 100 80 80 80 i00 80 100 80 100 94 100 100 100 100 100 100 80 90 90

+ + + + + + + + + -

-

PE

Steroids

Cyclop

Azat

Anticoag

Follow-up (years)

Outcome

+ + + +

+ + +

+ +

+ +

0.48 9.49 1.67 1.76 3.33 4.85 1.80 2.48 0.15 2.21

2 ESRF ESRF 3 3 3 ESRF 3 ESRF 1

5.38 1.14 0.97 1.64 2.25 0.98 0.04 0.97 9.15 2.12 0.21 0.10 1.73 0.73 2.59 2.83 0.58 0.24 2.88 0.38

1 2 2 1 ESRF ESRF ESRF ESRF 2 1 ESRF ESRF 2 ESRF 2 ESRF ESRF ESRF ESRF ESRF

+ -

+ + + +

+ + + MP

+ + -

+ + -

+ + + + + + -

+ + + + + + + + + + + + + +

+ + + + + + + + + + + + + + + +

+ MP + + + + + + + + + + + + + + + + + +

+ + + + + + + + + + + + + + + + + +

+ + + + + + + + + + + -

+ + + + + + + + + + + + + + + + + +

.

.

.

.

.

PD, Peritoneal dialysis; SLE, systemic lupus erythematosus; PE, plasma exchange; HSP, Henoch-Schrnlein purpura; ME methylprednisolone; MCGN, mesangiocapillary glomerulonephritis type I, type III; ESRF, end-stage renal failttre; PAN, polyarteritis nodosa; GBM, anti-glomerular basement membrane glomemlonepba'itis; Mic Pol, microscopic polyar-

teritis; PSGN, post-streptococcal glomemlonephritis; Cyclop, cyclophosphamide; Azat, azathioprine; Anti-coag, anti-coagulants; 1, glomerular filtration rate (GFR) 1, >80 ml/min per 1.73 me; 2, 30< GFR