[Immunologic aspects of the nephrotic syndrome]

Evidence that immunological mechanisms playing a major role in certain forms of nephrotic syndrome are obtained from immunopathologic observations, by analogy to certain form of experimental renal disease and by alterations in serum complement and complement component levels. This group of disease includes a variety of glomerulonephritis in which antigen-antibody-complexes and anti-glomerular basal membrane antibodies play a role in their pathogenesis. There are also evidences that the alternate complement pathway may be involved in certain forms of immune related glomerulonephritis. The precise etiology of idiopathic nephrotic syndrome having unique characteristics separating it from nephrotic syndrome associated with glomerulonephritis, is yet unknown. However, there are some circumstantial evidences depending on clinical observations that it may be an immunological disorder. It is possibly produced by a systemic abnormality of T-cell function resulting in the secretion of a circulating chemical mediator, toxic to the glomerular basement membrane; but there is not yet direct proof to substantiate this hypothesis.