Changing perspectives in 95 children with poststreptococcal acute glomerulonephritis (PSAGN) in our hospital between 1979 and 1988 are reported. Between 1961 and 1970 an average of 31 +/- 6.3 patients/year with PSAGN were treated and 70% had antecedent pyoderma. In the present study antecedent pharyngitis was observed in 59 children and pyoderma in 36. In comparison to the decade ending in 1970 our data show: (1) a marked decline in the prevalence of PSAGN (P = less than 0.0005), (2) a predominance of antecedent pharyngeal infection (P = 0.044), (3) a decline in urban and an increase in rural patients with PSAGN (P = 0.0483); and in the last decade: (1) a predominance of antecedent pharyngeal infection in children over 6 years of age (P = 0.0009) and (2) a predominance of antecedent pyoderma in black children (P = 0.0004).

A case of colistln nephrotoxicity without history of previous renal disease was studied by light and electron microscopy of a renal biopsy specimen obtained 11 days after discontinuation of the drug. The histologic picture showed variation from early acute necrosis to regeneration of the damaged renal epithelium. There appeared to be difference of susceptibility among individual tubular epithelial cells to sodium colistinmethanesulfonate in the development of nephrotoxicity. Morphological changes were essentially similar in both the proximal and distal tubules. Indentation of the nuclear membranes was conspicuous and appeared to be demonstrable earlier than the cytoplasmic alterations. ACTA PATH. JAP. 19: 55˜67, 1969.

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