Renal Lesions in Leptospirosis

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Abstract
Renal function studies and kidney biopsies were performed in 4 patients presented with renal insufficiency and acute Leptospira pomona infection. The renal lesion in all patients revealed acute interstitial nephritis. There was no evidence of immunologically mediated disease in 3 patients who were biopsied 7, 8 and 8 days, respectively, following the onset of symptoms. The 4th, in whom there was no evidence of prior renal disease, and whose biopsy was performed 16 days after symptoms began, showed glomerular C1q [complement component 1 fragment q], and C3 [complement component 3] immunofluorescence and mesangial, subepithelial and intramembranous dense deposits by EM. Circulating immune complexes were also demonstrated in this patient. Thus, in this instance at least, the reneal leions of L. pomona infections can be immunologically mediated. Because this may well be a transient phase, the timing of investigations could be crucial to its detection.

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