Proteinuria and the nephrotic syndrome in homozygous sickle cell anaemia
Nicholson, G.D.; Amin, U.F.; Alleyne, G.A.
West Indian Medical Journal 29(4): 239-246
1980
ISSN/ISBN: 0043-3144 PMID: 7467279 Document Number: 166965
Thirteen patients with homozygous sickle cell anemia (SCA) and clinical and laboratory evidence of renal glomerular disease were studied to determine the pathogenesis of proteinuria and the nephrotic syndrome. Correlation was made between the clinical presentation and the renal histological changes in assigning the patients to various groups. Patients with active leg ulcers and acute presentations showed evidence of poststreptococcal glomerulonephritis and spontaneous resolution of the renal disease in the majority of cases. Other groups showed persistent proteinuria and/or progressive deterioration of renal function. Serological evidence of streptococcal infection was present in all groups regardless of whether the renal histology showed a proliferative or membranoproliferative glomerulonephritis. Streptococcal glomerulonephritis is apparently an important cause of proteinuria and the nephrotic syndrome in SCA; chronic leg ulceration may facilitate the acquisition of such disease.