Asymptomatic Glomerulonephritis After Nonstreptococcal Upper Respiratory Infections

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Abstract
Previously healthy military personnel (240) with non-streptococcal upper respiratory infections were prospectively studied to define the incidence and clinicopathologic characteristics of possible virus-associated glomerulonephritis. Of nine patients without preceding streptococcal infection who had erythrocyte casts on urinalysis and glomerulonephritis on biopsy, 4 had a reduction in total hemolytic complement and 5 had serologic evidence of infection with adenovirus, influenza A or influenza B. Initial renal biopsy showed focal or diffuse mesangial proliferation in all 9, with mesangial C3 [complement component 3] deposits in 6 specimens. Repeat biopsy in 3 showed histologic improvement, loss of immunofluorescent staining or both. Sequential creatinine clearances were reduced to 74-90 ml/min .cntdot. 1.73 m2 in 5 patients for the duration of follow-up. Non-streptococcal upper respiratory infection is frequently associated with glomerulonephritis. Abnormal glomerular structure and decreased creatinine clearances may persist for at least 2-8 mo.