Increased Urinary Glomerular Basement Membrane Products in Pyelonephritis

Abstract

Soluble glomerular basement membrane products (gbm-p) are excreted in urines of normal children, but increased excretion of these products occurs in various types of glomerular disease. [Abstracts, Soc. for Ped. Res. p.9, May 1969.] Since pyelonephritis is a disease in which glomeruli may be involved, gbm-p were searched for in the urines of such patients. Twenty-four hour urine samples from 83 subjects were concentrated and examined by immunodiffusion against sheep anti-human gbm globulin. Slight to marked increases in gbm-p exceeded the level found in 3 patients with acute glomerulonephritis. In 2 additional children with acute pyelonephritis the quantity of gbm-p excreted equaled that found in one of the patients with glomerulonephritis. Patients with treated pyelonephitis, cystitis, and congenital renal anomalies without infection excreted gmb-p in the range found of healthy controls. Sterile urine samples from normal subjects were inoculated wi th a strain of E. coli (0–6) isolated from a patient with acute pyelonephritis, and tested by the same technique in order to rule out cross-reactivity with bacterial antigen. All these tests were negative. These preliminary studies suggest: (1) that increased excretion of gbm-p may be manifestation of glomerular involvement in acute pyelonephritis, and (2) that this technique might prove useful in the differential diagnosis of upper vs. lower urinary tract infection.