Abstract
In the previous papers, Matsumura et al. reported that food sensitivity play an important role on the etiology of postural proteinuria (PP). Namely, PP was obviously induced by trial ingestion of allergenic foods such as milk, egg, soybean, pork, redbean and/ or mackerel, and clearly removed by their elimination. Avoidance also made the accompanying symtoms improved. PP in this series dealt with the proteinuria induced by the erect lordotic posture. In other words, our subjects should strictly be called lordotic proteinuria (LP).In this paper, 9 cases of LP, aged 5 to 13 yrs. and consisted of 6 girls and 3 boys, were reported, in which LP still persisted even after eliminating a few or more suspected foods and finally disappeared or markedly improved by eradicating infectious foci such as inflammed tonsils and adenoid as well as decayed teeth. The periods necessary for inducing improvement were 2/3- 12 (average 3.9) months after eradication. The infectious foci removed were as follow carious teeth in 1 case ; tonsils in 3; carious teeth and tonsils in 4 ; tonsils and adenoid in one. On light microscopy of 2 renal biopsy specimens, one showed minimal abnormalities including a focal slight increase in mesangial cells, and another a diffuse slight mesangial proliferation. In the latter, immunofluorescent study revealed deposits of IgM in mesangial regions and walls of vasa afferentia as well as along the capillary loops. Deposits of IgG and β1C were also seen along the peripheral capillary walls of glomeruli. On the electron microscopic examination, focal foot process fusions and so on were observed in both cases.From these findings it might be suggested that focal infection coexisting with food sensitivity play an important role in the pathogenesis of postural proteinuria.
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