Glomerulonephritis Subacute

The major pathologic presentation of solvent associated nephropathy is that of anti-glomerular basement membrane disease [39] but epimembraneous and subacute proliferative glomerulonephritis have also been demonstrated. In addition, Narvarte et al. [40] reported on a patient with ulcerative colitis in which chronic interstitial nephritis developed that later was attributed to long-term exposure to organic solvents. 

FIGURE 47-5. Cl inical presentations of glomerulonephritis. AP, anaphylactoid purpura GBM, glomerular basement membrane GN, glomerulonephritis HUS, hemolytic uremic syndrome MPGN, membranoproliferative glomerulonephritis SBE, subacute bacterial endocarditis SLE, systemic lupus erythematosus TTP, thrombotic thrombocytopenic purpura. 

Several disease states can alter complement concentrations. Complement concentrations frequently are found to be lower than normal during states of acute inflammation. Low complement concentrations often are associated with systemic lupus erythematosus, rheumatoid arthritis, collagen-vascular disorders, poststreptococcal glomerulonephritis, and subacute bacterial endocarditis. These states of apparent low complement concentrations generally are due to high rates of complement utilization that cannot be compensated for by increased complement synthesis. ... 

Serum complement levels are useful to distinguish between various forms of acute nephritis that may be due to either a primary renal disorder or a systemic disease. Glomerular diseases associated with decreased complement levels include systemic diseases such as systemic lupus erythematosus, subacute bacterial endocarditis, and cryoglobulinemia, and renal diseases such as acute poststreptococcal glomerulonephritis. Glomerular diseases in which serum complement levels are normal include systemic diseases such as Goodpasture s syndrome and renal diseases such as IgG-IgA nephropathy, antiglomerular basement membrane disease, and immune-complex disease. 

The earlier doeumentation of chronic renal disease and hydrocarbon exposure consists of case reports, and this data was summarized by Churchill et al. describing Goodpasture s syndrome in 15 adults, epimembranous glomerulonephritis in 5 adults, and subacute proliferative glomerulonephritis in one adult. The hydrocarbon exposures were for solvents in 12 patients, gasoline in 4, gasoline-based paint in 3, jet fuek mineral turpentine and un-... 

Systemic lupus erythematosus Subacute bacterial endocarditis Glomerulonephritis Gram-positive bacteremia Inherited angioedema Inherited deficit... 

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