glomerulonephritis

A 72-year-old male patient, suffering from suppurative cel-lulitis of the skin and myositis during the previous 3 weeks, was hospitalized at our facility because of acute renal fail-ure with Coke-coloured haematuria and severe hyperten-sion. His serum creatinine was 700.2 μmol/L and his anti-streptolysin-O titre was ×340 (normal range: ×20–150). SerumC3was 59mg/dL (normal range: 79–140) and serum C4 was 26 mg/dL (normal range: 13–35). Anti-neutrophil cytoplasmic antibodies (ANCA) of myeloperoxidase and proteinase-3 were negative. We suspected that he had post-streptococcal acute glomerulonephritis (PSAGN) and per-formed a renal biopsy. Fifteen glomeruli including three sclerosed ones revealed global endocapillary hypercellularity with numerous neu-trophils on light microscopy (left side in Figure 1). Thes