Role of coxsackievirus B4 in the pathogenesis of acute glomerulonephritis

Coxsackievirus B(4) was isolated from the throat, nose, blood, stools and urine of a 9-year-old boy with acute glomerulonephritis and a pneumonitis. Neutralization test showed a greater than fourfold rise in the antibody titre to coxsackievirus B(4). The antistreptolysin O titre was elevated, but the complement component was within the normal range. The importance of the coxsackievirus B(4) in the pathogenesis of acute glomerulonephritis is clearly indicated; however, further investigations are needed to understand the details of the virus-kidney interaction.

Evaluation of streptozyme and antistreptolysin O tests in streptococcal pyodermal nephritis

The evaluation of the streptozyme test in sera from 34 patients with streptococcal pyodermal nephritis was studied. Ninety-seven percent of the patients developed high titers of antistreptozyme antibodies on the first bleeding after hospitalization, in contrast to only 40% of patients who developed elevated antistreptolysin O titers. The high antistreptozyme titers declined during convalescence and reached normal levels in the sixth month after onset of the disease. The most significant fall in titers occurred between 1 and 2 months from the onset of disease. The streptozyme test may be particularly helpful as a rapid screening test for antibodies in streptococcal pyodermal nephritis.

Immunological studies in children undergoing tonsillectomy

Serum IgA concentrations in children undergoing tonsillectomy for recurrent sore throats were lower than those of a control population. Haemophilus influenzae was usually grown from children with lower IgA concentrations, near to and below 2 SD below the control mean. Their values were significantly lower than those from patients from whom β haemolytic streptococci were grown. Some of the children with low IgA had low antistreptolysin titres and little or no lymphocyte response to PHA. There was no relationship between the immunological findings and the pre-operative severity of symptoms, but there was with the incidence of infection in the post-operative year. These findings will necessitate reappraisal of surgery and prophylactic antibiotics in the two groups separately.

These findings suggest that tonsils from children presenting with indistinguishable syndromes are infected with different bacteria, depending on the immunological function of the child. Since tonsillectomy is common, there appears to be clinical relevance for the range of immunological function near to or within the `normal limits'.