The Relation of the Serum Antistreptolysin Titer to the Exacerbation in Chronic Glomerulonephritis

Earle, David P.; Seegal, David; Lyttle, John D.; Loeb, Emily N.; Jost, Elizabeth L.

doi:10.1172/jci101325

Cited by 7 publications

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“…The relation of the serum antistreptolysin titer response to the exacerbation in chronic glomerulonephritis is discussed in the accompanying paper (10).…”

Section: Summary Of Materialsmentioning

confidence: 99%

The Serum Antistreptolysin Titer in Chronic Glomerulonephritis

Earle¹,

Loeb²,

Seegal³

et al. 1942

J. Clin. Invest.

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Previous reports (1, 2, 3) have dealt with the serum antistreptolysin titer response in acute glomerulonephritis. Seegal, Lyttle and their associates (2) found that 94 per cent of 116 consecutive cases of acute glomerulonephritis were associated with significant rises in antistreptolysin titer. Longcope (3) found an increased antistreptolysin titer in the acute stage of 72 per cent of 36 cases of acute hemorrhagic nephritis (type A). These studies show that the acute infections, which so typically precede the onset of acute glomerulonephritis, are generally due to the group A hemolytic streptococcus. Winkenwerder, McLeod and Baker (4), however, described another type of glomerulonephritis (type B), characterized by an insidious onset of edema and a progressive downhill course, and usually associated with chronic upper respiratory infection. Although group A hemolytic streptococci were often recovered from the upper respiratory passages of these patients (type B), Longcope (3) showed that rises in antistreptolysin titer were a rarity. Indeed, the titers were frequently found to be abnormally low.The present study is based on the examination of the serum antistreptolysin titer response in patients with chronic glomerulonephritis. This study was undertaken with full knowledge of the difficulty of establishing the diagnosis of chronic glomerulonephritis. In this series of 81 patients presenting the picture of chronic glomerulonephritis, 24 are known to have died. Autopsies performed on 13 of these revealed chronic glomerulonephritis. A biopsy of the kidney established the diagnosis in one additional case. In 23 other cases, attacks typical either of acute glomerulonephritis, i.e., the onset of the disease, or of an exacerbation of chronic glomerulonephritis, have been observed. Thus, the diagnosis of glomerulonephritis seems to have been established beyond doubt in 37 of the 81 cases. The remaining 44 patients were thoroughly studied and, in the opinion of several experienced observers, there was no evidence of renal disease other than chronic glomerulonephritis.The patients comprising this study have been observed over periods of from 4 months to 8 years. Twelve patients were followed for less than one year, the short follow-up being due to early death in 10 instances. Fifty-two, or 64 per cent, were followed for 2 or more years. Sera for the determination of the antistreptolysin titer were obtained at varying intervals in each patient. In hospitalized cases, determinations were made once or twice a week. It was not possible to obtain tests with this frequency in the ambulatory patients seen at the clinic. However, in the majority of these instances, determinations were made at intervals of from 1 to 4 months. In addition, the patients were instructed to report to the clinic whenever an infection developed and were then studied weekly.Todd (5) developed the technique for the determination of serum antistreptolysin and with minor modifications (2) this technique has been employed throughout the present studies. The...

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“…The relation of the serum antistreptolysin titer response to the exacerbation in chronic glomerulonephritis is discussed in the accompanying paper (10).…”

Section: Summary Of Materialsmentioning

confidence: 99%

The Serum Antistreptolysin Titer in Chronic Glomerulonephritis

Earle¹,

Loeb²,

Seegal³

et al. 1942

J. Clin. Invest.

Self Cite

View full text Add to dashboard Cite

show abstract

“…In rheumatic fever the latent period remained constant in each exacerbation. Subsequently, Earle, Seegal, Lyttle, Loeb, and Jost (20) showed that in contrast to rheumatic fever the exacerbation in seven of eight cases of nephritis was fully developed before the antistreptolysin titer increased. Recently Fischel and Gajdusek (21) observed a serological difference between nephritis and rheumatic fever.…”

Section: Introductionmentioning

confidence: 99%