Evidence of an autologous immune complex pathogenic mechanism in acute poststreptococcal glomerulonephritis

Kidney Int. 1978 Nov;14(5):501-10. doi: 10.1038/ki.1978.155.


Clinical and experimental studies have suggested a role for antiimmunoglobulins in the pathogenesis of glomerulonephritis associated with streptococcal infection. We attempted to localize anti-IgG in the kidneys of 22 patients who had renal biopsies performed 7 to 66 days after the onset of acute poststreptococcal glomerulonephritis (APSGN). In addition to routine localization of immunoglobulins and C3, specimens were stained with neuraminidase-treated, heat-aggregated, and unmodified IgG. Twelve biopsies showed staining with fluorescein-labeled human neuraminidase-treated IgG. A lesser number gave positive staining with the other IgG preparations. Following treatment of slides with 0.01 M citrate buffer, seven previously negative biopsies showed positive staining with neuraminidase-treated IgG. The demonstration of anti-IgG by these methods was possible in 19 out of 22 biopsies. It correlated best with the presence of C3 and IgG, and to a lesser extent with IgM, in the renal glomerulus. These results and our previous finding of elevated levels of serum anti-IgG early in the course of APSGN, and as early as 8 days following the antecedent streptococcal infection, support a role for anti-IgG in the immune pathogenesis of APSGN. Although our series of studies support the hypothesis that anti-IgG is formed to an IgG modified enzymatically by streptococcal product, the formation of this autoantibody to IgG incorporated in an exogenous (streptococcal antigen-antibody) complex can not be ruled out.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Antigen-Antibody Complex*
  • Autoantibodies / immunology*
  • Basement Membrane / immunology
  • Child
  • Child, Preschool
  • Complement C3 / analysis
  • Female
  • Fluoresceins
  • Glomerulonephritis / etiology*
  • Glomerulonephritis / immunology
  • Humans
  • Immunoglobulin G / analysis
  • Immunoglobulin M / analysis
  • Kidney Glomerulus / immunology
  • Male
  • Streptococcal Infections / complications*
  • Streptococcal Infections / immunology
  • Time Factors


  • Antigen-Antibody Complex
  • Autoantibodies
  • Complement C3
  • Fluoresceins
  • Immunoglobulin G
  • Immunoglobulin M