In addition to the classical picture of\u00a0endocapillary proliferative and exudative\u00a0glomerulonephritis, patients with acute postinfectious glomerulonephritis may manifest a broad\u00a0spectrum of various histomorphological and\u00a0immunohistological changes which may reflect\u00a0the stage of the disease, their responsivness to\u00a0the disease and\/or the specific type of infection.\u00a0The data on the correlation between histomorphological changes and immune deposits are still\u00a0sparse. The purpose of this study was to evaluate these, most probably key relationships in\u00a0the pathogenesis related to the duration of the\u00a0disease and type of infection.\u00a0This retrospective study involved 113 kidney biopsies from 91 men and 22 women with the diagnosis of postinfectious glomerulonephritis. The\u00a0tissue samples were examined by standard light\u00a0and immunofluorescent microscopy techniques.\u00a0Mesangial, endocapillary and mesangiocapillary\u00a0proliferation, exudation, tubulo-interstitial changes,
\nvascular lesions and glomerular immune deposits\u00a0were evaluated semiquantitatively using the generally recognized nephropatological methods.\u00a0Extracapillary proliferation and global and segment\u00a0glomerulosclerosis were evaluated as a percentage of the affected glomeruli. Immune deposits\u00a0demonstrated the following three immunofluorescent patterns: garland, starry sky and mesangial.\u00a0Streptococcus was confirmed to be causally related to postinfectious glomerulonephritis in 54% of\u00a0cases. Staphylococcus was found in 6% of cases\u00a0and both, streptococcus and staphylococcus in\u00a05%. In 35% of cases no causative agent was\u00a0demonstrated. IgG and complement component C3 deposits with a starry sky pattern were\u00a0confirmed to be significantly associated with with\u00a0glomerular endocapillary proliferation and exudation characteristic of the in the first month of the\u00a0disease course. A mesangial, often less intensive,\u00a0pattern of C3 deposits associated with mesangial\u00a0proliferation predominated in the second and\u00a0third month. A higher percentage of sclerosed\u00a0glomeruli and increased intensity of vascular\u00a0lesions during the course of the disease were not\u00a0statistically significant. In more than half the\u00a0patients tubulo-interstitial changes were found\u00a0independently of the duration of glomerulonephritis, but mostly to a limited extent. A garland pattern accompanied by a very intensive\u00a0endocapillary and mesangiocapillary proliferation and exudation was observed in 8 (7%)\u00a0patients exclusively in the first two months of the\u00a0disease. Extracapillary crescents were found in\u00a027 (24%) patients, but they were located only focally and involved a maximum of 38% of glomeruli.\u00a0They were noticed almost exclusively in the first\u00a0two months of the disease. There were some\u00a0unusual samples demonstrating endocapillary\u00a0proliferation (4\/14), exudative reaction (5\/14) and\u00a0glomerular capillary starry sky deposits (5\/14),\u00a0which persisted after three months of the course\u00a0of glomerulonephritis. In some cases, the intensity of inflammatory changes did not correlate with\u00a0the pattern and intensity of immune deposits.\u00a0Our study confirmed a significant association of\u00a0starry sky and garland pattern with endocapillary proliferation and exudation in the first, and\u00a0partly, the second month of acute postinfectious glomerulonephritis. The mesangial patern\u00a0of the C3 deposits and mesangial proliferation\u00a0are characteristic of the later phases of the disease. All deviations seem to be attributable to\u00a0individual differences in responsiveness as we\u00a0failed to prove the obvious differences depending on the type of infection. Only slightly more\u00a0frequent extracapillary crescents and IgA were\u00a0found in immune deposits in patients with\u00a0glomerulonephritis mediated by staphylococcal and undefined infectious agents.<\/p>\n","protected":false},"excerpt":{"rendered":"
In addition to the classical picture of\u00a0endocapillary proliferative and exudative\u00a0glomerulonephritis, patients with acute postinfectious glomerulonephritis may manifest a broad\u00a0spectrum of various histomorphological and\u00a0immunohistological changes which may reflect\u00a0the stage of the disease, their responsivness to\u00a0the disease and\/or the specific type of infection.\u00a0The data on the correlation between histomorphological changes and immune deposits are still\u00a0sparse. The purpose […]<\/p>\n","protected":false},"author":17,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[336,425,440],"tags":[],"class_list":["post-2654","post","type-post","status-publish","format-standard","hentry","category-2-1999-archive","category-infectious-diseases","category-pathology"],"acf":[],"yoast_head":"\n