Renal lesions in acute rheumatic fever.

In the past 4 years, four patients with acute rheumatic fever and abnormalities of renal function, urinary sediment, or both have undergone percutaneous renal biopsy at this institution. Distinctly different renal lesions were found and included focal glomerulonephritis, classic acute exudative poststreptococcal glomerulonephritis, mesangioproliferative glomerulonephritis, and severe interstitial nephritis. In each case, the clinical abnormalities were transient. In this report we describe the clinical and pathologic findings in each of these patients to stress the variability of renal lesions that may accompany acute rheumatic fever.