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The Nephrotic Syndrome in Papua New Guinea: Aetiological, Pathological and Immunological Findings
Author(s) -
Powell K. C.,
Meadows R.,
Anders R.,
Draper C. C.,
Lauer C.
Publication year - 1977
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1977.tb03680.x
Subject(s) - nephrotic syndrome , medicine , immunology , antibody , antigen , glomerulonephritis , immune complex , immunoglobulin m , serology , immunofluorescence , pathology , immunoglobulin g , virology , kidney
Summary:The nephrotic syndrome in Papua New Guinea: aetiological, pathological and immunological findings. K. C. Powell, R. Meadows, R. Anders, C. C. Draper and C. Lauer, Aust. N.Z. J. Med., 1977, 7, pp. 243–252. Studies were carried out on 34 patients with the nephrotic syndrome within Papua New Guinea to determine the aetiology, with special reference to the role of P. malariae. Biopsies were taken and examined by light microscopy, with a few additionally examined for immunofluorescence. Sera were studied for titre of malarial antibody, presence of select viral antibodies, Australia Antigen, immunoglobulins IgA, IgG and IgM, and for the third component of complement (C3). The selectivity of proteinuria was examined by a method using IgG and transferrin. Control subjects were used when appropriate. Histological findings showed a wide range of changes with the Minimal Lesion type being very uncommon. Proliferative lesions accounted for 24 of the 34. Focal lesions were uncommon, in contrast to findings of an earlier publication concerning New Guinea patients. Immunofluorescence studies on nine showed the presence of complement, IgG, IgM or IgE, findings accepted as consistent with the concept of immune complex disease. The serum results showed a low level of total IgG, a low IgG specific for P. malariae, a normal level of IgM specific for P. malariae and a raised total IgM. These serological findings, along with the histological findings, are strongly against P. malariae being a common cause of the nephrotic syndrome. The viral findings excluded type B hepatitis virus and some arboviruses, as causing the nephrotic syndrome. The ASOT titres were usually normal and the VDRL readings all non‐reactive. Leptospira! infections were excluded as a cause. The cause(s) of the nephrotic syndrome in Papua New Guinea remains obscure.