Browsing by Author "Van Buuren, A. J."

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    A child with the nephrotic syndrome associated with endemic syphilis. : a case report
    (Health and Medical Publishing Group (HMPG), 1978-07) Le Roux, F. B.; Van Buuren, A. J.
    A 21-month old infant with endemic syphilis who presented with nephrotic syndrome is described. Clinically, the features correlated well with those of renal disease associated with secondary syphilis. The onset of renal disease in association with syphilis after early infancy may be a valuable aid in drawing attention to the possibility of endemic syphilis. Morphologically the features were those of an immune complex-mediated glomerulonephritis. We regard the presence of a large number of immature looking glomeruli as a retrogressive phenomenon.
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    Low plasma pyridoxal-5'-phosphate levels in children with the nephrotic syndrome
    (Health & Medical Publishing Group, 1985) Van Buuren, A. J.; Shephard, G. S.; Labadarios, D.
    Of 35 children with the nephrotic syndrome in relapse, 88% were found to have low circulating plasma pyridoxal-5'-phosphate (PLP) levels. Remission of the syndrome was associated with spontaneous normalization of plasma PLP levels in 23 such children. A significant (P < 0.001) positive correlation (r = 0.81) was found between plasma albumin and PLP levels and a significant (P < 0.001) negative correlation (r = -0.66) between plasma PLP and serum cholesterol levels. The low plasma PLP levels may be due to enhanced urinary excretion of albumin-bound PLP in view of the severe proteinuria which characterizes the nephrotic syndrome.
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    Nephrotic syndrome in Namibian children
    (Health & Medical Publishing Group, 1999) Van Buuren, A. J.; Bates, W. D.; Muller, N.
    Background and objectives. Patterns of nephrotic syndrome vary between regions and countries, and influence approaches to management. In the mid-1970s the University of Stellenbosch became involved in providing tertiary care to Namibia, including a paediatric nephrology service. The aim of this study was to document the clinical, pathological and outcome features of nephrotic syndrome in Namibian children. Subjects. Seventy black Namibian children with nephrotic syndrome were managed from 1975 to 1988. Sixty-eight renal specimens (67 biopsies and 1 autopsy specimen) were evaluated. Results. Twenty-nine of the 70 children (41.4%) were hepatitis B virus (HBV) carriers, of whom 25 (86.2%) were male. Of the 29, 26 had predominantly membranous glomerulonephritis (MGN), 1 mesangiocapillary glomerulonephritis (MCGN), and 1 focal segmental glomerulosclerosis (FSGS); 1 child in advanced renal failure was not biopsied. Five children (7.4%) showed minimal change disease (MCD), 11 (16.2%) FSGS and 15 (22.1%) diffuse mesangial proliferative glomerulonephritis (DMP). The remaining 10 children showed diffuse glomerulosclerosis (6), MCGN (3) and endocapillary proliferative GN (1). Four of the 5 children with MCD went into remission on immunosuppressive treatment. Of the 15 with DMF, 4 improved spontaneously and only 1 of those treated did not improve. Only 2 of those with FSGS improved on treatment. The children with HBV-associated MGN and MCGN were offered symptomatic rather than specific treatment. Thirteen children presented with degrees of chronic renal failure. Eight are known to have died, 3 of relentless nephrotic syndrome and 4 (of whom 3 were HBV carriers) of end-stage renal failure. One child died of penicillin anaphylaxis. Conclusions. The pattern of nephrotic syndrome in black Namibian children differed greatly from the non-African pattern elsewhere in that MCD was uncommon and HBV-associated GN was the most common single group. The most frequent pattern of HBV-associated GN was MGN with some mesangiocapillary features showing marked male predominance. MCD and DMP were potentially treatable and could only be identified by biopsy. HBV carrier rates exert a major influence on the proportions of morphological subgroups of nephrotic syndrome in children. As these HBV carrier rates alter in future due to the influence of vaccination and urbanisation, the relative size of nephrotic subgroups seems likely to alter.