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December 1978

Renal Cortical Necrosis

Arch Intern Med. 1978;138(12):1866. doi:10.1001/archinte.1978.03630370072037

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To the Editor.—  The article on "Renal Cortical Necrosis Following Streptococcal Infection" in the Archives (137:1196-1197, 1977), reminded me of a patient I cared for in 1962.This was a 6-year-old boy with acute poststreptococcal glomerulonephritis (antistreptolysin titer >625 Todd units) complicated by approximately 16 days of anuria. His recovery was very slow and he never achieved a diuresis. A roentgenogram of his abdomen was obtained on Dec 21, 1962 (Fig 1) and showed fine "eggshell"like calcifications in a thin rim surrounding each kidney.The patient died in November 1963, approximately one year later. The kidneys, ureters, and bladder were removed and a radiograph was taken (Fig 2) There was extensive calcification within the renal parenchyma bilaterally. The gross autopsy specimen (Fig 3) showed calcifications on the renal surface. Microscopic examination of the renal tissue disclosed bilateral cortical necrosis with calcification.Since the calcifications in the kidney had appeared within weeks

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