Immune complex glomerulopathy in a child with food hypersensitivity

• Published in: Kidney international Vol. 30; no. 4; pp. 592 - 598
• Main Authors: McCrory, Wallace W., Becker, Carl G., Cunningham–Rundles, Charlotte, Klein, Renate F., Mouradian, Janet, Reisman, Lewis
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.1986; Nature Publishing
• Subjects: Adolescent; Antigen-Antibody Complex - analysis; Biological and medical sciences; Combined Modality Therapy; Cross Reactions; Diet Therapy; Dietary Proteins - adverse effects; Eosinophilia - etiology; Eosinophilia - immunology; Eosinophilia - therapy; Food Hypersensitivity - complications; Food Hypersensitivity - immunology; Food Hypersensitivity - therapy; Gastroenteritis - etiology; Gastroenteritis - immunology; Gastroenteritis - therapy; Glomerulonephritis; Glomerulonephritis - etiology; Glomerulonephritis - immunology; Glomerulonephritis - therapy; Humans; Immune Complex Diseases - etiology; Immune Complex Diseases - immunology; Immune Complex Diseases - therapy; Male; Medical sciences; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Prednisone - therapeutic use; Human; Glomerulonephritis; Allergy; Immunopathology; Urinary system disease; Child; Food; Immune complex
• ISSN: 0085-2538; 1523-1755
• DOI: 10.1038/ki.1986.226

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 ofthe 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 hem-agglutinating 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 causitive antigens and prednisone therapy, CIC levels decreased to 16,000 µg/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.