[Recurrent hematuria of glomerular origin]. / Hematuria recurrente de origen glomerular

Nine hundred and forty children with hematuria were admitted to the nephrology service from 1958 to 1973. Percutaneous renal biopsies were performed in all of them. Thirty cases out of this group had recurrent hematuria and constitute the clinical material of this study. The clinical picture was: acute nephrotic syndrome in 19; monosymptomatic hematuria in 8, anaphylactoid purpura nephritis in 2, and hematuria associated with nephrotic syndrome in one patient. All patients with nephritic syndrome showed in their biopsies various types of glomerular lesions; most of the patients with monosymptomatic hematuria had normal glomeruli; at the light microscopy, the immunofluorescence was positive in some of them. Both patients with anaphylactoid nephritis showed diffuse endocapillary and focal extracapillary proliferation and in the only one with nephrotic syndrome, the hematuria was familial and the biopsy showed features of Alport's syndrome. Twenty-four patients who were followed for over two years showed no relationship between the age of onset, sex, initial significant proteinuria, hypertension, frequency of bouts of hematuria and the clinical evolution. At the end of the study, 7 patients had prolonged remission: the light microscopy showed normal glomeruli, endocapillary proliferation and endo and extracapillary proliferation with less than 30% of the glomeruli affected by "crescents". The remaining cases were still active and one of them with endo and extracapillary glomerulonephritis with more than 30% of the glomeruli affected by "crescents", developed chronic renal insufficiency. In conclusion, the prognosis of recurrent hematuria of glomerular origen is related with the type of glomerular lesions and constitutes an indication for renal biopsy. Renal specimens must be studied under light microscopy and immunofluorescence techniques; electromicroscopy is required when hematuria is present in more than one member of the family.

[Immunopathology of nephropathy secondary to anaphylactoid purpura]. / Inmunopatología de la nefropatía secundaria a púrpura anafilactoide (NPA)

With the purpose of contributing to the study of the pathogenesis of the nephropathy of anaphylactoid purpura (NPA), investigation was made of the presence and extension of immunoglobuline deposits, complement factors and fibrinogen in renal biopsies of 15 patients with NPA, correlating the findings with glomerular lesions seen at the light microscope. Fibrin and IgA deposits were found in all biopsies in mesangium, while C3 was detected only in 5 cases with potentially progressive lesions: 3 with PEEF, one with PEED and one with MP, being negative in PSF and PE cases, which are potentially reversible. The extension of deposits was diffuse or segmentary, without the existence of a precise correlation with the different morphological types. It is concluded that the immunopathologic pattern found in NPA is quite characteristics, different from that of postinfectious acute glomerulonephritis and that there seems to exist relation between findings of C3 with progression of the glomerular lesion.