[Morphology and pathogenesis of glomerular renal lesions in gold nephropathy]. / Zur Morphologie und Pathogenese glomerulärer Nierenveränderungen bei der Gold-Nephropathie.

Histological, immunofluorescent and electron microscopical investigations on the glomerular renal lesions in gold-induced nephropathy were performed by analyzing biopsy materials from 9 patients with rheumatoid arthritis treated by Sanocrysin (gold sodium thiosulfate). The morphological and immunofluorescent main changes consisted in the characteristic pattern of immune complex nephritis as membranous glomerulonephritis on the one hand (4 cases) and as mesangioproliferative glomerulonephritis (4 cases) on the other hand; in one case there could be demonstrated a focal proliferative glomerulonephritis similar to that observed as visceral manifestation of rheumatoid arthritis in the kidney. These different types of glomerular alterations in gold nephropathy evidently are related to th duration and immunological activity of the main disease and to the individual immune reactivity of the body as a whole determined by this, and not at all, by the combination of gold additionally with other antiinflammatory, especially antirheumatic drugs. The possible pathogenesis of nephropathy is discussed with special regard to definite effects of gold on the immune system.