Balkan nephritis. A synthetic view on 50 studied cases

Epidemiological, clinical pathological investigations concerning Balkan nephritis (BN) have revealed some particular aspects which define this condition as a distinct nosologic entity. Its endemic familial character and its occurrence restricted to some limited geographic areas in Bulgaria, Yugoslavia and Romania, are highly unusual. BN leads to chronic impairment of the renal function which is, however, not constantly associated with edema and hypertension. The duration of the disease is prolonged; death takes place from uremia within five to ten years. Gross pathologic changes are consisting of severe bilateral atrophy of the kidneys, with structural changes suggesting a 'renal cirrhosis'. The etiology of the disease is obscure. Investigations carried out by means of electron microscopy and immunofluorescence tests are suggesting that the pathogenesis is rather complex. The role of a persistent tolerated or slow, latent virus infection in certain families, that of some toxic factors, and the implication of autoimmune mechanisms are to be considered.