The American Journal of Medicine
Volume 76, Issue 6 , Pages 1106-1112, June 1984

Rapidly progressive glomerulonephritis in a patient with syphilis:☆

Identification of antitreponemal antibody and treponemal antigen in renal tissue

  • Patrick D. Walker, M.D.

      Affiliations

    • Corresponding Author InformationRequests for reprints should be addressed to Dr. Patrick D. Walker, Department of Pathology, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, Louisiana 70112.
    • From the Departments of Pathology and Internal Medicine (Nephrology), Tulane University School of Medicine, New Orleans, Louisiana.
    • ,
  • Erin C. Deeves, B.S.

      Affiliations

    • From the Departments of Pathology and Internal Medicine (Nephrology), Tulane University School of Medicine, New Orleans, Louisiana.
    • ,
  • Glayol Sahba

      Affiliations

    • From the Departments of Pathology and Internal Medicine (Nephrology), Tulane University School of Medicine, New Orleans, Louisiana.
    • ,
  • John D. Wallin, M.D.

      Affiliations

    • From the Departments of Pathology and Internal Medicine (Nephrology), Tulane University School of Medicine, New Orleans, Louisiana.
    • ,
  • William M. O'Neill Jr., M.D.

      Affiliations

    • From the Departments of Pathology and Internal Medicine (Nephrology), Tulane University School of Medicine, New Orleans, Louisiana.

New Orleans, Louisiana USA

Accepted 23 June 1983.

Abstract 

A 37-year-old man presented with biopsy-proved rapidly progressive glomerulonephritis and a strongly positive fluorescent treponemal antibody result. The patient was treated with hemodialysis, plasmapheresis, methylprednisolone, and penicillin, with rapid improvement and stabilization of renal function. Antibody was eluted from the frozen renal tissue and demonstrated a strongly positive reaction to the treponemal antigen when used in the fluorescent treponemal antibody test. In addition, when specific rabbit antitreponemal antiserum was applied to the frozen renal sections, there was a strongly positive reaction. Although syphilis has been associated with membranous glomerulopathy and post-infectious glomerulonephritis, this appears to be the first case of latent syphilis in which rapidly progressive glomerulonephritis has been identified. The presence within the glomeruli of treponemal antigen and antitreponemal antibody supports the association of these two entities.

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☆ This work was presented in part at the 71st Annual Meeting of the United States-Canadian Division of the International Academy of Pathology, Boston, Massachusetts, March 1982.

PII: 0002-9343(84)90866-0

The American Journal of Medicine
Volume 76, Issue 6 , Pages 1106-1112, June 1984

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