Skip to main content
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1973 May;48(5):375–381. doi: 10.1136/adc.48.5.375

Congenital syphilis and glomerulonephritis with evidence for immune pathogenesis

J Wiggelinkhuizen, R O C Kaschula, C J Uys, R H Kuijten, J Dale
PMCID: PMC1648370  PMID: 4267344

Abstract

In 3 infants with congenital syphilis the dominant clinical manifestation of syphilitic kidney disease was the nephrotic syndrome. Mesangioendothelial proliferation was present in 2 cases and mixed proliferative glomerulonephritis with crescent formation in the third. The severity of the clinical and histopathological abnormalities could be related to the apparent duration of the illness.

In all 3 cases immune complex deposition could be shown within and along the epithelial aspect of the glomerular basement membrane on light, electron, and immunofluorescent microscopy. These features, together with a reduced total serum haemolytic complement, suggest an immune pathogenesis of the glomerulonephritis associated with early congenital syphilis.

Full text

PDF
376

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BROPHY E. M., ASHWORTH C. T., ARIAS M., REYNOLDS J. ACUTE SYPHILITIC NEPHROSIS IN PREGNANCY. Obstet Gynecol. 1964 Dec;24:930–937. [PubMed] [Google Scholar]
  2. Bhorade M. S., Carag H. B., Lee H. J., Potter E. V., Dunea G. Nephropathy of secondary syphilis. A clinical and pathological spectrum. JAMA. 1971 May 17;216(7):1159–1166. [PubMed] [Google Scholar]
  3. Braunstein G. D., Lewis E. J., Galvanek E. G., Hamilton A., Bell W. R. The nephrotic syndrome associated with secondary syphilis. An immune deposit disease. Am J Med. 1970 May;48(5):643–648. doi: 10.1016/0002-9343(70)90016-1. [DOI] [PubMed] [Google Scholar]
  4. Brentjens J. R., Feltkamp-Vroom T. M., Tiddens H. A., Kuyten R. H. Localization of plasma proteins in kidneys of children with diffuse nephropathies, studied by an indirect immunofluorescent technique. Acta Paediatr Scand. 1969 Jul;58(4):374–384. doi: 10.1111/j.1651-2227.1969.tb04734.x. [DOI] [PubMed] [Google Scholar]
  5. Dixon F. J., Cochrane C. G. The pathogenicity of antigen-antibody complexes. Pathol Annu. 1970;5:355–379. [PubMed] [Google Scholar]
  6. Dixon F. J. The pathogenesis of glomerulonephritis. Am J Med. 1968 Apr;44(4):493–498. doi: 10.1016/0002-9343(68)90050-8. [DOI] [PubMed] [Google Scholar]
  7. Falls W. F., Jr, Ford K. L., Ashworth C. T., Carter N. W. The nephrotic syndrome in secondary syphilis: report of a case with renal biopsy findings. Ann Intern Med. 1965 Dec;63(6):1047–1058. doi: 10.7326/0003-4819-63-6-1047. [DOI] [PubMed] [Google Scholar]
  8. Germuth F. G., Jr, Senterfit L. B., Pollack A. D. Immune complex disease. I. Experimental acute and chronic glomerulonephritis. Johns Hopkins Med J. 1967 Apr;120(4):225–251. [PubMed] [Google Scholar]
  9. Hill L. L., Singer D. B., Falletta J., Stasney R. The nephrotic syndrome in congenital syphilis: an immunopathy. Pediatrics. 1972 Feb;49(2):260–266. [PubMed] [Google Scholar]
  10. Kaplan B. S., Wiglesworth F. W., Marks M. I., Drummond K. N. The glomerulopathy of congenital syphilis--an immune deposit disease. J Pediatr. 1972 Dec;81(6):1154–1156. doi: 10.1016/s0022-3476(72)80251-8. [DOI] [PubMed] [Google Scholar]
  11. Koffler D., Schur P. H., Kunkel H. G. Immunological studies concerning the nephritis of systemic lupus erythematosus. J Exp Med. 1967 Oct 1;126(4):607–624. doi: 10.1084/jem.126.4.607. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Lewis E. J., Couser W. G. The immunologic basis of human renal disease. Pediatr Clin North Am. 1971 May;18(2):467–507. doi: 10.1016/s0031-3955(16)32562-7. [DOI] [PubMed] [Google Scholar]
  13. MITCHELL J. Congenital syphilis with acute nephritis. Br Med J. 1951 Feb 24;1(4703):396–396. doi: 10.1136/bmj.1.4703.396. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. McCluskey R. T. Evidence for immunologic mechanisms in several forms of human glomerular diseases. Bull N Y Acad Med. 1970 Oct;46(10):769–788. [PMC free article] [PubMed] [Google Scholar]
  15. McDonald R., Wiggelinkhuizen J., Kaschula R. O. The nephrotic syndrome in very young infants. Am J Dis Child. 1971 Dec;122(6):507–512. doi: 10.1001/archpedi.1971.02110060077013. [DOI] [PubMed] [Google Scholar]
  16. Michael A. F., Jr, Drummond K. N., Good R. A., Vernier R. L. Acute poststreptococcal glomerulonephritis: immune deposit disease. J Clin Invest. 1966 Feb;45(2):237–248. doi: 10.1172/JCI105336. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. PAPAIOANNOU A. C., ASROW G. G., SCHUCKMELL N. H. Nephrotic syndrome in early infancy as a manifestation of congenital syphilis. Pediatrics. 1961 Apr;27:636–641. [PubMed] [Google Scholar]
  18. Pollner P. Nephrotic syndrome associated with congenital syphilis. JAMA. 1966 Oct 17;198(3):263–266. [PubMed] [Google Scholar]
  19. Stickler G. B., Shin M. H., Burke E. C., Holley K. E., Miller R. H., Segar W. E. Diffuse glomerulonephritis associated with infected ventriculoatrial shunt. N Engl J Med. 1968 Nov 14;279(20):1077–1082. doi: 10.1056/NEJM196811142792003. [DOI] [PubMed] [Google Scholar]
  20. TAITZ L. S., ISAACSON C., STEIN H. Acute nephritis associated with congenital syphilis. Br Med J. 1961 Jul 15;2(5245):152–153. doi: 10.1136/bmj.2.5245.152. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Ward P. A., Kibukamusoke J. W. Evidence for soluble immune complexes in the pathogenesis of the glomerulonephritis of quartan malaria. Lancet. 1969 Feb 8;1(7589):283–285. doi: 10.1016/s0140-6736(69)91038-1. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES