Immune complex glomerulopathy in a child with food hypersensitivity.
This report describes the occurrence of immune complex glomerulonephritis in a patient with eosinophilic gastroenteritis and food hypersensitivity. A coincident allergen injection may have been a contributing factor in the sudden development of the nephrotic syndrome. Markedly elevated levels of circulating immune complexes (greater than 6400 mg/dl) were found containing kappa-casein and bovine serum albumin (BSA), the latter predominating. Markedly elevated serum BSA hemagglutinating titers were also present (1:40,960). Cross-reacting precipitating antibodies to BSA, beef, and pork were demonstrated, but not to flounder or ovalbumin. Renal biopsy revealed immune complex glomerulonephritis with BSA, immunoglobulins M and G and complement deposited focally in the glomerular basement membrane. With strict dietary limitation of identified causative antigens and prednisone therapy, CIC levels decreased to 16,000 micrograms/dl and serum BSA antibody hemagglutinating titer fell 32-fold over a period of 15 months. There was prompt symptomatic relief and amelioration of signs of nephritis. The patient was able to consume a diet normal in protein and caloric content, and statural catch-up growth occurred. Recognition of food antigens to which the patient was hypersensitive provided a rationale for the relief of the gastrointestinal disturbance, growth stunting, and renal disease.
D000293:Adolescent; D000936:Antigen-Antibody Complex / Q000032:analysis; D003131:Combined Modality Therapy; D003429:Cross Reactions; D004035:Diet Therapy; D004044:Dietary Proteins / Q000009:adverse effects; D004802:Eosinophilia / Q000209:etiology / Q000276:immunology / Q000628:therapy; D005512:Food Hypersensitivity / Q000150:complications* / Q000276:immunology / Q000628:therapy; D005759:Gastroenteritis / Q000209:etiology / Q000276:immunology / Q000628:therapy; D005921:Glomerulonephritis / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D006801:Humans; D007105:Immune Complex Diseases / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D008297:Male; D011241:Prednisone / Q000627:therapeutic use
D000936:Antigen-Antibody Complex; D004044:Dietary Proteins; D011241:Prednisone