RENAL FUNCTION STUDIES IN ACUTE SYPHILITIC NEPHROSIS BEFORE AND AFTER TREATMENT WITH PENICILLIN

Abstract

A case report of an 18-yr.-old colored male with acute syphilitic nephrosis is presented because of the rather unusual opportunity to study renal function by more recent clearance methods before and after treatment with penicillin. The patient had generalized edema, hypoproteinemia, marked albuminuria, cylinduria, hypercholesterolemia and generalized lymphadenopathy. Blood pressure was normal, basal metabolic rate lowered and serology strongly positive. There were no cardiac abnormalities, no azotemia and no anemia. An oral lesion was found to be darkfield positive. Ordinary renal function tests gave normal results. Renal plasma flow, glomerular filtration rate and maximal tubular excretory capacity were determined employing p-aminohippurate and inulin. Studies done just before the patient was started on a 15-day course of intramusc. penicillin indicated a moderate reduction of both glomerular and tubular function with slightly lowered filtration fraction. Studies done after penicillin therapy revealed a return toward normal function. Glomerular filtration increased relatively more than did effective renal plasma flow. Clinical and laboratory improvement began before completion of antiluetic treatment.