PERSISTENT GLOMERULONEPHRITIS FOLLOWING HEMOLYTIC-UREMIC SYNDROME - IMMUNOPATHOLOGICAL AND MORPHOLOGICAL-STUDIES

  • 1 January 1977
    • journal article
    • research article
    • Vol. 29  (3) , 361-368
Abstract
Immunopathological and ultrastructural studies were carried out on kidney biopsies of 8 children with a persistent nephropathy (PN) following the hemolytic-uremic syndrome (HUS). Significnt amounts of in vivo-bound immunoglobulins [Ig] and C3 [complement component] were demonstrated by immunofluorscence methods in the glomeruli of all the cases, with a nodular pattern along the capillary walls. In 4 cases studied, C1q and C4 were also demonstrated, with an identical distribution. Transmission electron-microscope studies revealed a marked thickening of the glomerular basement membrane, and the existence of an electron-dense material with an intramembranous and subepithelial localization. With the exception of 1 case, serum complement studies did not present major modifications. Coagulation studies reveal that alterations observed in acute HUS were not present in the PN. An immune mechanism of glomerular damage may operate in the pathogenesis of the PN observed after HUS, leading to a normocomplementemic, chronic glomerulonephritis. Although a hypothetical antigen (or perhaps several antigens) remains to be demonstrated, immunofluoresence and EM studies suggest the deposition of immune complexes in the renal lesions.