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Übergang einer Glomerulonephritis vom Poststreptokokkentyp in eine rapid-progressive Glomerulonephritis

Transformation of a poststreptococcal type glomerulonephritis into a rapidly progressive glomerulonephritis

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Summary

In the morphological course of a poststreptococcal type glomerulonephritis in a 37-year old patient without evidence of streptococcal infection crescents of Bowman's capsule developed after 4 months. The clinical course was rapidly progressive (the patient was uremic 5 months after onset) in contrast to the normal fair prognosis of the poststreptococcal type glomerulonephritis. Two renal biopsies were examined at an intervall of 4 months. Both showed closely packed immunecomplex deposits (humps) on the glomerular basement membrane immuno- and electronmicroscopically. It is suggested that the confluence of glomerular immunecomplex deposits in the poststreptococcal type glomerulonephritis is a prognostically unfavourable sign.

Zusammenfassung

Im Verlauf einer morphologisch nicht sehr schweren Glomerulonephritis vom Post-streptokokkentyp traten bei einem 37jährigen Patienten nach 4 Monaten Proliferationen der Bowmanschen Kapselepithelien auf. Der klinische Verlauf war im Gegensatz zum normalen gutartigen Verlauf der Glomerulonephritis vom Poststreptokokkentyp rapid-progressiv, die chronische Niereninsuffizienz war bereits 5 Monate nach Krankheitsbeginn im Terminalstadium. Beide Nierenbiopsien, die im Abstand von 4 Monaten entnommen wurden, zeigten immunhistologisch und elektronenmikroskopisch dichtliegende, teilweise konfluierende Immunkomplexablagerungen (humps) auf der glomerulären Basalmembran. Diese dichtliegenden Immunkomplexablagerungen werden bei diesem Patienten als prognostisch ungünstiges Zeichen gewertet.

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Authors and Affiliations

  1. Pathologisches Institut der Universität Tübingen, Germany

    H. Fischbach, H. Breker & G. H. Thoenes

  2. Medizinische Klinik I des Städtischen Krankenhauses Köln-Merheim, Germany

    H. Fischbach, H. Breker & G. H. Thoenes

  3. II. Medizinische Klinik der Universität München, Germany

    H. Fischbach, H. Breker & G. H. Thoenes

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  1. H. Fischbach
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  2. H. Breker
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  3. G. H. Thoenes
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Fischbach, H., Breker, H. & Thoenes, G.H. Übergang einer Glomerulonephritis vom Poststreptokokkentyp in eine rapid-progressive Glomerulonephritis. Klin Wochenschr 55, 259–264 (1977). https://doi.org/10.1007/BF01484726

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  • DOI: https://doi.org/10.1007/BF01484726

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