[Kidney morphology in children with meningococcal infection]

The kidneys of 30 children aged 1 month to 5 years who died of meningococcal infection were studied. Three variants of the kidney damage were distinguished on the basis of morphometric parameters. These variants corresponded to the stages of the infectious-toxic shock. The 1st variant observed in the reversible shock stages was characterized by arteriolar spasm and circulation shunts. The 2nd variant corresponded to initial manifestations of the disseminated vascular coagulation and was characterized by a combination of spasm and paralytic arteriola dilatation with a predominant thrombosis of the juxtamedullar glomeruli. The 3rd variant, the stage of the organ alterations, was followed by development of glomerular thrombotic microangiopathy with tubular epithelial necrosis in the proximal tubules this being the morphological counterpart of the hemolytico-uremic syndrome.