Family contacts of post streptococcal acute glomerulonephritisThis study was conducted in family contacts of post-streptococcal acute glomerulonephritis (PSAGN) assessing socio-economic status (SES), streptococcal activity (SA) and nephritic activity (NA). One hundred and forty three families were studied. The mean number of persons per family was 6.9; mean age of contacts was 20.8 years; 48.2% were males; the number of persons per bedroom was greater than 4 in 23.4% of the cases and that of persons per bed greater than 2 in 21.4% of them. Quality of neighbourhood and housing was in the lowest grade of a conventional classification in 55.2% and 62.5% of the families respectively. Group A streptococci was isolated in 13.5% of contacts from throat swabs and in 47.7% from skin lesions. Significant titres of antistreptolysine O (333 UT) were detected in 20%, hematuria in 10.6% and low C 3 in 17.7% of contacts; the frequency of these last two criteria was 2.6% and in 1.3% it was associated to evidence of streptococcal infection. Comparing this results with those from control families of the same health district, there were significant differences in SES and SA, in detriment of PSAGN families. It is concluded that SES is worse and SA is greater in PSAGN family contacts than in control families. It is possible to detect subclinical NA in family contacts of PSAGN cases, supporting the idea of primary prevention activities in this high risk group. (

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Acute glomerular nephritis in childrenForty live ehildren (23 boys) 22to 15 years old (mean age 7.7 years) with clinical and histological evidence of acute glomerular nephritis (AGN) were followed by 30 months. A.II patients were studied with percutaneous renal biopsies in tlic first month after the begining of the disease (mean 20 days) and in 31 patients, a second renal biopsy was done: in 12 at x 194 days (range 171 to" 212 days) and in 19 at x 590 days (range 418 to 999 days). With only 5 exceptions (11.1%) all patients recalled clinical evidence of antecedent cutaneous (37.8%), respiratory (51.1%) or combined cutaneous and respiratory infections (11.1%) but group A bctha hcmolitycus estrep toco ecus (GABHE) was only isolated from six patients, probably because of previous antibiotic treatment. Edema and hypertension dissapearcd in a mean of 8.8 and 4.3 days respectively. Haematuria was present in only 44%of the patients in the first urine examination, protemuria in 51% and eilindruria in 29.9% of the cases, but at last, hematuria was demonstrated in 41 /45 patients; proteinuria, that was present in a!3 cases without hematuria, finally ocurred in 95% of all the affected children and eilindruria was detected in 64%of the total series. A good correlation was found in the histologic study between the magnitude of the lesions at optic and electronic microscopy. In the first biopsy all patients showed segmental intramembranous, inrnune deposits. In the second series of renal biopsies the intensity of the lesions was, clearly, lesser at six months and the microscopical findings were already normal in three cases at 590 days.