STUDY FOR ETIOLOGY OF NEPHRITIS. I. CLINICAL STUDY.

Abstract

1) In more than half of the cases which were admitted to our hospital within 3 months after developing acute nephritis, streptococcal infection was recognized. Among 7 cases in which streptococci were isolated ; group A type 12 β-hemolytic streptococci were found in 4 cases ; group A un-identifiable type in one case ; un-identifiable group in one case, from which it can be deduced that infection of streptococci, especially that of group A type 12 has close relation to the development of nephritis. There is a case in which nephritic symptom was revealed by the alleged infection of Influenza B more than 10 years after conva-lescnce of acute nephritis. 2) As to the case of chronic nephritis, except the time of exacerbation, no streptococcal infection was proved both in those initiated by acute nephritis and in those not apparently initiated by acute nephritis Therefore, it seems that there is some other reason for its aggravation. 3) As to the exacerbated cases of chronic nephritis, though at the time of exacerbation of chronic nephritis initiated by acute nephritis, streptococcal infection could not be proved, in many cases nephritis developed within a week after infection. In one case, however, exacerbation was recognized to be resulted from the alleged infection of Influenza B. Among exacerbation cases of chronic nephritis not apparently initiated by acute nephritis, in two cases out of three, preceding infection of streptococci was proved, while in the remaining one, latent stage lasted for 3 weeks. From these facts it may be concluded that the exacerbation of chronic nephritis results either from streptococcal infection or from infection of something other than streptococci, and mechanism of development of nephrites in these two categories is different. 4) As to the group of nephrotic syndrome, the cases in which preceding infection was recognized were few and no streptococci were isolated. It seems that the relationship between the development of this disease and streptococcal infection is not quite close. There is only one case of interstitial nephritis in which though preceding infection was recognized, no streptococcal infection was proved. 5) Neither aggravation nor improvement of nephritis resulted from tonsillectomy operated upon nephritic patients. Between the temporary worsening of urinary findings following the tonsillectomy and the isolation or non-isolation of streptococci from extracted tonsil culture, there seemed to be no interrelation whatsoever. Therefore, it seems that tonsil itself gives some impact upon kidney.