Adhikari M, Coovadia H M, Chrystal V
Ann Trop Paediatr. 1983 Mar;3(1):17-24. doi: 10.1080/02724936.1983.11748262.
Membranous nephropathy is the most frequent histological category among black children with nephrotic syndrome. In this study 31 African children with this condition are described. There were more boys than girls and the peak age was four to 11 years. The incidence of this histological category and clinical outcome in the African children were similar to these features in adults with membranous nephropathy. During a follow-up period of up to six years there was spontaneous remission in a third of patients, persistent proteinuria in just over a third (37.5%) and persistent relapse in under a third (29.2%). Hypertension occurred more frequently (19.3%) and spontaneous remission less often (33.3%) than in children with membranous nephropathy elsewhere. Hypertension, the lower remission rate and persistence of proteinuria during the course of the disease were similar to the disease seen in adults. Renal failure was not encountered in any patients. Steroids were of little value in the treatment of these children. Five children (16.2%) had associated infections. HBsAg was present in three of six children tested.
膜性肾病是患肾病综合征的黑人儿童中最常见的组织学类型。本研究描述了31例患有这种疾病的非洲儿童。男孩多于女孩，发病高峰年龄为4至11岁。非洲儿童中这种组织学类型的发病率和临床结局与成人膜性肾病的这些特征相似。在长达六年的随访期内，三分之一的患者出现自发缓解，略多于三分之一（37.5%）的患者持续蛋白尿，不到三分之一（29.2%）的患者持续复发。与其他地方的膜性肾病儿童相比，高血压出现得更频繁（19.3%），自发缓解的情况更少（33.3%）。高血压、较低的缓解率以及疾病过程中蛋白尿的持续存在与成人所见疾病相似。所有患者均未出现肾衰竭。类固醇对这些儿童的治疗几乎没有价值。5名儿童（16.2%）伴有感染。在接受检测的6名儿童中，有3名乙肝表面抗原呈阳性。
