title: The role of complement, immunoglobulin and bacterial antigen in coagulase-negative staphylococcal shunt nephritis.
abstract: We describe three patients with arrested hydrocephalus in whom glomerulonephritis developed secondary to Staphylococcus epidermidis bacteremia from an infected ventriculoatrial shunt. Investigation of the immune-mediated renal disease associated with this chronic infection showed that (1) complement depletion during the acute phase of bacteremia and nephritis was predominantly via the classic pathway; (2) rheumatoid factor was associated with bacteremia, fever, proteinuria and low complement levels; (3) early complement components (C1q, C4, C3), immunoglobulin (predominantly immunoglobulin M [IgM], Staph. epidermidis antigen(s) and electron denxe subendothelial deposits were localized within the renal glomerulus; (4) C1q, and IgM derived from patient serums, were the most prominent in vitro immunoreactants to Staph. epidermidis cell walls; and (5) the causative organisms, Staph. epidermidis, shared common antigens with Staph. aureus, and antibody from patient serums cross reacted with extracts from both of these organisms.
mesh_terms: D000942:Antigens, Bacterial; D002557:Cerebrospinal Fluid Shunts; D002675:Child, Preschool; D003165:Complement System Proteins; D003429:Cross Reactions; D003450:Cryoglobulins; D005260:Female; D005455:Fluorescent Antibody Technique; D005921:Glomerulonephritis / Q000209:etiology / Q000276:immunology*; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D007136:Immunoglobulins; D007678:Kidney Glomerulus / Q000276:immunology; D008297:Male; D011183:Postoperative Complications; D012217:Rheumatoid Factor; D018805:Sepsis / Q000150:complications; D013203:Staphylococcal Infections / Q000276:immunology*; D013210:Staphylococcus / Q000276:immunology; D013211:Staphylococcus aureus / Q000276:immunology
chemical_list: D000942:Antigens, Bacterial; D003450:Cryoglobulins; D007136:Immunoglobulins; D003165:Complement System Proteins; D012217:Rheumatoid Factor