Abstract
We report two cases of acute poststreptococcal glomerulonephritis (APSGN) with persistent renal function impairment developed in brothers. Both patients were admitted to a foster home as they were from a single-father family. No other child in the foster home developed APSGN. Although their symptoms were typical, early renal biopsies were carried out because it was not possible to prove the streptococcal infection in the elder brother, and renal function impairment rapidly progressed in the younger brother. Both of them were diagnosed as having APSGN with the findings of endocapillary proliferative glomerulonephritis under light microscopy and positive immunofluorescent staining for the nephritis-associated plasmin receptor. Their glomerular lesions show no findings necessitating aggressive treatments such as crescent formation or the `garland type', and favorable outcomes were accomplished with conservative treatments. Because proper management in the early phase is important in APSGN patients, early renal biopsy is thought to be useful for determining the treatment plan as well as long-term follow-up in cases of rapidly progressive nephritis or diagnostic difficulty in acute aggravation of chronic nephritis.
