[Viral antigens in kidney biopsies of children with glomerulonephritis]. / Virusnye antigeny v bioptatakh pochechnoi tkani u detei s glomerulonefritom.

A relationship between clinical forms of glomerulonephritis and incidence of viral antigens in renal tissue was revealed: Hepatitis B virus antigens (HBsAg) are more frequently detected in the glomeruli in the patients with nephrotic glomerulonephritis, Herpes simplex antigens are detected in the glomeruli in mixed glomerulonephritis, and cytomegaloviral and Herpes simplex antigens are detected in the epithelium of the proximal canaliculi in patients with hematuric glomerulonephritis. No correlations between the persistence of Herpes simplex type 1, cytomegalovirus, and HBsAg in the renal tissue were detected. HBsAg is detected in the renal tissue mainly in the children without free HBsAg in the blood serum. This may be indicative of an important role of specific immune complexes in the pathogenesis of glomerulonephritis associated with hepatitis B viral infection. The results point to an appreciable contribution of a persistent viral infection to the progress of glomerulonephritis.

[Plasmapheresis in the combined therapy of progressive forms of glomerulonephritis]. / Plazmaferez v kompleksnoi terapii progressiruiushchikh form glomerulonefrita.

29 patients aged 6-16 with glomerulonephritis lasting 4-5 years received multimodality treatment with plasmapheresis as a component. The majority of the patients suffered from primary glomerulonephritis in mesangio- or membrano-proliferative morphological variants. Previous long-term conventional therapy (prednisolone, cytostatics, anticoagulants and antiaggregation drugs) failed. The test course comprised 1-3 plasmapheresis sessions (centrifuge method on [symbol: see text] apparatus), cyclophosphamide or maintenance methyl-prednisolone pulse therapy, heparin and curantil. One-third of the patients achieved remission lasting from 5 months to 3 years, in the other one-third the improvement was as short as 2-4 weeks, and the last one-third appeared non-responders. Improvement of clinical indices occurred in parallel with trends to reduction in the levels of CIC, IgG, B-lymphocytes, T-helpers, inhibition of lymphocyte succinate dehydrogenase activity, better phagocytosis. No complications which may prohibit plasmapheresis use in glomerulonephritis were observed. Adjuvant plasmapheresis use in glomerulonephritis treatment needs further studies.

[The first experience of using membranotropic agents in the treatment of the nephrotic syndrome]. / Pervyi opyt ispol'zovaniia membranotropnykh sredstv v lechenii nefroticheskogo sindroma.

To treat children suffering from the nephrotic syndrome, use was made of the membrano-stabilizing agents: zaditen that also has an antiallergic action; dimephosphon, a membrano-stabilizer and immunomodulator. The basis for differentiated use of the drugs was formed by the examination data which enabled one to identify the signs of atopy in children with the hormone-dependent nephrotic syndrome, marked signs of the instability of cellular membranes and different immunologic deviations in children with the hormone-resistant variety of the nephrotic syndrome. During zaditen treatment, the majority of the children with the hormone-resistant nephrotic syndrome manifested an appreciable decrease of the process activity; in some cases, including those with hormone dependence, the treatment with prednisolone could be reduced. In part of the children with the hormone-resistant nephrotic syndrome, the treatment with dimephosphone resulted in a decrease of proteinuria, reduced the instability of cellular membranes, and improved the immunologic parameters.