Gortazar Hijar P, López Vega M E, González Mendoza A
Bol Med Hosp Infant Mex. 1981 Nov-Dec;38(6):903-9.
Clinical and pathological data of 450 children ranging from 1.5 to 16 years of age with acute post-infectious glomerulonephritis observed at the Children's Hospital of Centro Médico de Occidente (IMSS), with a follow-up of 12 years are presented. The outstanding features of this review are the following: a very high incidence of the disease in 1978 and 1979, coinciding with an epidemic of scarlet fever. From 127 patients a renal biopsy was obtained; in 79.5% the histological picture srowed proliferative endocapillary glomerulonephritis (PEG), 5.5% corresponded to focal proliferative endo and extracapillary glomerulonephritis (FPEEG), 11% were diffuse proliferative endo and extracapillary crescent-forming glomerulonephritis (DPEEG) and 3.9% membranoproliferative glomerulonephriteis (MPG). On clinical basis, the evolution of the disease through a 12 years follow-up period has demonstrated normal renal function in 91% of all patients. Correlation of the results of histologic examination with the clinical course of the disease have demonstrated a good prognosis in PEG, whereas DPEEG and MPG have shown a poor evolution. The data here presented confirms the usefulness of the renal biopsy to predict the clinical evolution of post-infectious glomerulonephritis.
本文呈现了西墨西哥医疗中心(IMSS)儿童医院观察到的450例年龄在1.5至16岁之间的急性感染后肾小球肾炎患儿的临床和病理数据,随访时间为12年。本次综述的突出特点如下:1978年和1979年该病发病率极高,与猩红热流行同时发生。从127例患者身上获取了肾活检样本;79.5%的组织学表现为增生性毛细血管内肾小球肾炎(PEG),5.5%为局灶性增生性毛细血管内和毛细血管外肾小球肾炎(FPEEG),11%为弥漫性增生性毛细血管内和毛细血管外新月体形成性肾小球肾炎(DPEEG),3.9%为膜增生性肾小球肾炎(MPG)。基于临床情况,在12年的随访期内,该疾病的发展表明91%的患者肾功能正常。组织学检查结果与疾病临床进程的相关性表明,PEG预后良好,而DPEEG和MPG的发展情况较差。本文所呈现的数据证实了肾活检对预测感染后肾小球肾炎临床发展的有用性。