Search

The authors discuss about thirty-five personal observations of intercapillary glomerulonephritis. In twenty-five cases hematuria was the initial finding. In most cases plasma complement and immunologic parameters were normal. In three observations segmentary and focal intercapillary lesions were seen while in the remaining cases lesions were diffuse. Immunohistochemical studies allow to determine two groups of intercapillary glomerular disease : in thirty cases (85%) mesangial IgA deposits existed as seen in Berger's disease : in five cases no IgA was detected but IgM and/or C'3 was present. Twenty-eight patients were followed during an average period of twenty-eight months. In ten cases initial symptoms regressed completely. Nine patients remained unchanged with no subsequent aggravation. Two patients developed renal insufficiency with hypertension and in one case the existing disease worsened. Although no therapy seems undeniably effective, systematic antibiotics during infections bouts preceded apparent regression of disease in one third of our patients.

Eighteen hemodialysed patients having a plasma calcium level of 2 mmol/l or less were treated by 1-alpha-OH-D3 at a mean dose of 1.56 microgram per day for six to twelve months. Calcium levels rose significantly. The concomitant rise in phosphorus levels required large doses of aluminum hydroxide. Alkaline phosphatase and parathormone levels were significantly lowered. Seven patients had calcium levels above 2.75 mmol/l and subsequently developed metastatic calcifications. Therefore plasma calcium levels should be carefully monitored during treatment and maintained at normal levels. In twelve cases bone histomorphometric studies were done. When bone demineralization is a prominent feature, satisfactory osteoid tissue mineralization can be obtained, while bone resorption remains unchanged.