Acute rheumatic fever with extracapillary glomerulonephritis and the nephrotic syndrome.

A 34 year old woman is described in whom carditis, arthritis, fever, leukocytosis and a high sedimentation rate developed two weeks after a streptococcal infection. The patient also had the nephrotic syndrome and rapidly progressive renal insufficiency. The renal biopsy specimen showed acute extracapillary (crescentic) glomerulonephritis. The initial response to corticosteroid therapy was good, but later a slowly progressive renal function impairment was seen.