Asymptomatic Glomerulonephritis After Nonstreptococcal Upper Respiratory Infections

  1. MICHAEL C. SMITH, M.D.;
  2. JAMES H. COOKE, M.D.;
  3. DONALD M. ZIMMERMAN, M.D.;
  4. JULIO J. BIRD, M.D.;
  5. B. LYNN FEASTER, M.D.;
  6. ROBERT E. MORRISON, M.D.; and
  7. BERNHARD E. F. REIMANN
  1. Dr. Rer. Nat.
    Cleveland, Ohio; and El Paso, Texas

    Abstract

    Two hundred forty previously healthy military personnel with nonstreptococcal upper respiratory infections were prospectively studied to define the incidence and clinicopathologic characteristics of possible virus-associated glomerulonephritis. Nine patients without preceding streptococcal infection had erythrocyte casts on urinalysis and glomerulonephritis on biopsy. Of these nine, four had a reduction in total hemolytic complement and five had serologic evidence of infection with adenovirus, influenza A, or influenza B. Initial renal biopsy showed either focal or diffuse mesangial proliferation in all nine, with mesangial C3 deposits in six specimens. Repeat biopsy in three showed histologic improvement or loss of immunofluorescent staining, or both. Sequential creatinine clearances were reduced to 74 to 90 mL/min · 1.73 m2 in five patients for the duration of follow-up. We conclude that nonstreptococcal upper respiratory infection is frequently associated with glomerulonephritis and that abnormal glomerular structure and decreased creatinine clearances may persist for at least 2 to 8 months.

    Article and Author Information

    • ▸From the Division of Nephrology, Department of Medicine, Case Western Reserve University School of Medicine and University Hospitals of Cleveland, Cleveland, Ohio; and the Departments of Medicine and Pathology, William Beaumont Army Medical Center, El Paso, Texas.

    • The opinions and assertions contained in this article are the private ones of the authors and are not to be construed as official or reflecting the views of the Department of the Army or the Defense Department at large.

    • ▸Requests for reprints should be addressed to Michael C. Smith, M.D.; University Hospitals of Cleveland, 2065 Adelbert Road; Cleveland, OH 44106.

      • Received March 20, 1979.
      • Accepted July 30, 1979.
    « Previous | Next Article »Table of Contents

    This Article

    1. Ann Intern Med November 1, 1979 vol. 91 no. 5 697-702
    1. » Abstract
    2. Full Text (PDF)

    Rapid Responses

    1. Submit a response
    2. No responses published

    Current Issue

    1. November 17, 2009, 151 (10)
    1. Alert me to current issues