Nephropathy in Cameroon: evidence for filarial derived immune-complex pathogenesis in some cases

This study was carried out in two parts. Part 1 consisted of an epidemiological survey of 1011 subjects aged 3-65 yrs from 2 adjoining villages hyper-endemic for Onchocerciasis and 890 subjects in a control area, relatively free from this infection but otherwise with a similar parasitological profile. There was a significantly higher prevalence of proteinuria in subjects from the onchocercal zone than in controls (observed difference greater than 5 1/2 times its standard error). Part 2 comprised detailed investigations, including renal biopsy, of 63 consecutive patients admitted into hospital with severe proteinuria and/or renal failure from a caption area extending into the onchocercal zone. There were a variety of causative factors, but in 9 cases filarial antigen was demonstrable in the immune-complex deposits in the kidney. A plenum of renal histopathological changes were seen in patients with onchocerciasis. The significance of these findings is discussed.