Nephron injury in the haemolytic-uraemic syndrome complicating bacillary dysentery

The electron microscopic appearances of renal biopsy material from four children who developed the haemolytic-uraemic syndrome as a complication of bacillary dysentery are described. Glomerular lesions present included deposits of fibrin and platelets, subendothelial rarefaction and lysis of endocapillary cells with or without necrosis of glomerular epithelial cells and periglomerular tissue. Tubular epithelial necrosis and cytoplasmic degeneration with an infiltrate of lymphocytes and plasma cells were also seen. It is likely that the different glomerular lesions result from thrombosis and obstruction of blood vessels at various levels of the intrarenal circulation. The tubulo-interstitial changes appear to be secondary to glomerular lesions.