Effect of Febrile Plasma, Typhoid Vaccine and Nitrogen Mustard on Renal Manifestations of Human Glomerulonephritis

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Abstract
Remissions have been observed to occur spontaneously in patients -with chronic diffuse glomerulonephritis in the nephrotic phase, and following accidental or induced infection. Since the febrile phase of infection may be accompanied by disturbance in renal hemodyna-mics, it seemed possible that these remissions might be related to the induced renal changes. On the other hand, HN2 prevents development of the Shwartzman phenomenon, and since there is reason to believe that glomerulonephritis may be the result of immunological alteration in renal tissue, it seemed conceivable that a common factor might be operative in infection and following the admn. of this agent. In this view it was conceivable that reactive factors might be present in the plasma of patients with acute infections which would produce remission of the nephrotic syndrome. Admn. of plasma from patients acutely ill with pneumococcal and streptococcal infections and admn. of typhoid vaccine to patients with glomerulonephritis failed to induce a remission. Therapeutic doses of HN2 in a patient with glomerulonephritis with minimal renal functional impairment was followed on 2 occasions by diuresis, marked reduction in proteinuria, and concomitant increase in the rate of glo-merular filtration. These results are consistent with a return of glomerular function towards normal. This study is being extended to include patients in earlier phases of glomerulonephritis to attempt to induce reversal of this disease by HN2.