[Paratuberculous nephritis].

Abstract

The paper shows tuberculous origin of bilateral diffuse nephritis in many patients. Etiology of nephritis can be proved using standard skin tests with microbal allergens, tuberculin in particular. Nephritis etiology can be proved by the presence of general reaction 1-2 days after introduction of the allergen. Local reaction alone indirectly evidence the nature of nephritis. In 72 patients with acute diffuse glomerulonephritis local reactions to Mantoux, Pirquet tests appeared positive in 69 of 72 patients. Focal and general reactions to these tests were documented in half (n = 36) patients. This group of paratuberculous nephritis consisted of seriously ill patients, all cases with common symptoms of nephritis (edemas, hypertension, hematuria) and all cases with changes in serous cavities. Tuberculosis foci in the chest were small or absent. In mild cases the recovery occurred after standard nonspecific treatment. Antituberculous chemotherapy was effective in severe and long-standing nephritis. In one case of lethal outcome paratuberculous nature of nephritis was proved morphologically. Streptococcal, staphylococcal allergy in skin tests was absent or mild, failed to produce general and focal reactions and therefore could not be considered as an etiological factor of acute nephritis in our patients.