[Hypocomplementemic membranoproliferative glomerulonephritis in a child with ulcerative colitis (author's transl)].

A 5 1/2 year old girl with hypocomplementemic membranoproliferative glomerulonephritis suffered from severe nephrotic syndrome. Despite intensive treatment with corticosteroids and immunosuppressive drugs the clinical state deteriorated. Three years after clinical onset of the disease the girl entered our regular hemodialysis program because of terminal renal insufficiency. After two weeks of intermittent hemodialysis she presented intestinal bleeding, which could not be stopped. One week later complete ileus developed and the child died. Before the onset of melaena no occult blood or mucus could be detected in the faeces. The autopsy revealed a severe ulcerative colitis with pseudopolyposis of the whole colon. In serum specimens still available colonic antigen could be detected by means of immunodiffusion using a rabbit antiserum against fetal colonic extract. Immunofluorescence studies showed granular deposits of immunoglobulins and complement along the glomerular capillary walls suggesting an immunogenesis of the glomerulonephritis by circulating immune complexes. The possibility of an interrelationship in the pathogenesis of both diseases is discussed. It should not be excluded that immune complexes formed in excess of colonic antigen have caused or perpetuated chronic glomerulonephritis.