TY - JOUR
T1 - Renal Disease in Children with the Acquired Immunodeficiency Syndrome
AU - Strauss, José
AU - Abitbol, Carolyn
AU - Zilleruelo, Gastón
AU - Scott, Gwendolyn
AU - Paredes, Ana
AU - Malaga, Serafin
AU - Montané, Brenda
AU - Mitchell, Charles
AU - Parks, Wade
AU - Pardo, Victoriano
AU - Schierbecker, J.
PY - 1989/9/7
Y1 - 1989/9/7
N2 - Of 155 children with the acquired immunodeficiency syndrome (AIDS) whom we evaluated during a 6 1/2 -year period, 12 were found to have proteinuria. Histologic studies of tissue from these 12 patients revealed a wide spectrum of renal disease: focal glomerulosclerosis in 5, mesangial hyperplasia in 5, segmental necrotizing glomerulonephritis in 1, and minimal change disease in 1. In addition, 6 had tubulointerstitial infiltrates, and 10 had glomerular dense deposits. All 10 renal specimens studied by electron microscopy contained endothelial tubuloreticular inclusions. The mean age (±SD) of the five patients with focal glomerulosclerosis when this condition was identified was 27 ± 19 months. All five had severe renal failure within a year and died of other causes during the following year. The mean age of the five patients with mesangial hyperplasia was 38 ± 31 months. Although none of them went on to have renal failure, four died within 8 ± 7 months. Ten of the 12 patients with proteinuria died during the study period. Of the two surviving, one had mesangial hyperplasia and the other had minimal change disease. We conclude that children who acquired human immunodeficiency virus (HIV) infection during the perinatal period may have renal disease, most often focal glomerulosclerosis, as is the case in adults, or mesangial hyperplasia. Although 5 of the 12 children we studied had renal failure during the study period, none died of it. Further studies are needed to determine the correlations between clinical and pathological features and the pathophysiology of AIDS nephropathy in children.
AB - Of 155 children with the acquired immunodeficiency syndrome (AIDS) whom we evaluated during a 6 1/2 -year period, 12 were found to have proteinuria. Histologic studies of tissue from these 12 patients revealed a wide spectrum of renal disease: focal glomerulosclerosis in 5, mesangial hyperplasia in 5, segmental necrotizing glomerulonephritis in 1, and minimal change disease in 1. In addition, 6 had tubulointerstitial infiltrates, and 10 had glomerular dense deposits. All 10 renal specimens studied by electron microscopy contained endothelial tubuloreticular inclusions. The mean age (±SD) of the five patients with focal glomerulosclerosis when this condition was identified was 27 ± 19 months. All five had severe renal failure within a year and died of other causes during the following year. The mean age of the five patients with mesangial hyperplasia was 38 ± 31 months. Although none of them went on to have renal failure, four died within 8 ± 7 months. Ten of the 12 patients with proteinuria died during the study period. Of the two surviving, one had mesangial hyperplasia and the other had minimal change disease. We conclude that children who acquired human immunodeficiency virus (HIV) infection during the perinatal period may have renal disease, most often focal glomerulosclerosis, as is the case in adults, or mesangial hyperplasia. Although 5 of the 12 children we studied had renal failure during the study period, none died of it. Further studies are needed to determine the correlations between clinical and pathological features and the pathophysiology of AIDS nephropathy in children.
UR - http://www.scopus.com/inward/record.url?scp=0024463139&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0024463139&partnerID=8YFLogxK
U2 - 10.1056/NEJM198909073211001
DO - 10.1056/NEJM198909073211001
M3 - Article
C2 - 2770791
AN - SCOPUS:0024463139
VL - 321
SP - 625
EP - 630
JO - New England Journal of Medicine
JF - New England Journal of Medicine
SN - 0028-4793
IS - 10
ER -