Нефротический синдром
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E.T.Bell: new techniques of stainingstaining
Bell used the new Mallory stain to revealveal subtlesubtle changes in the apparently normal glomerularmerular capillary wall in both “lipoid nephrosisis”” (1929)(1929) and (seen here) membranous nephropathypathy
Volhard and proteinuriaa
Volhard believedlieved forfor aa long time thatthat thethe tubular changesanges seenseen in nephrosisis (( shownshown in his Atlass ofof 1914)1914) were the causeause andand not the resultult ofof proteinuria,a, butbut byby
1931 admittedtted aa rolerole for the glomerulusmerulus::
“einer activen Sekretion vorwiegend und sichtbarhtbar inin denden Tubulivielleicht unter Mitbeteiligung der Glomeruli”meruli”
The birth of the term “nephroticrotic syndrome”
Henry Christian
(1875-1951)
HA Christian..
Nephrosis- a critiquecritique.. JAMA 1929; 93:93: 2323--2525
Although the termterm waswas introduced att thethe endend of the 1920s, itit camecame into wide use onlyonly 2020 years later
One of the first uses of the termterm “nephrotic sydnrome””
The same authors also had a paper in 19300 whichwhich againagain used “nephrotic syndrome” as the preferredrred termterm
Calvin and Goldberg’s 1931 definitionefinition of a “nephrotic syndrome”e”
“Before discussing the treatment of the nephrotic syndrome, there should be a fairly definite understanding of what is meant by this term ….. pure lipoid nephrosis…. resembles very closely the nephrotic phase of chronic glomerulonephritis …. the two conditions may resemble each other almost identically, both clinically and chemically, and so the findings presented by them are grouped as the nephrotic syndrome”
Nephrosis and nephrotic syndromerome 19311931
Introduction:
“it will be the purpose of this review to indicateicate thethe evidence in favour of the existence of … nephrosisnephrosis (“lipoid”, “genuine” etc.) and to comparee itit withwith thethe “nephrotic syndrome” in chronic glomerulonephritisrulonephritis and amyloidosis”
Conclusion:
“the nephrotic syndrome seems to be well establishedestablished clinically and pathologically as somethingg whichwhich isis not directly related to glomerulonephritiss oror inflammatory renal disease, although commonlymmonly associated with it. In this primary, uncomplicatedplicated form this syndrome is known as nephrosissis,, andand isis aa rare disease”
(Leiter L. Nephrosis. Medicine(Baltimore) 1931;135931;135--242)242)
The spread of the term nephrotichrotic syndrome
•Only occasional papers used it duringring thethe 1930s:
•Leiter (1931)
•Calvin and Goldberg (1931)
•Tappan (1935)
•Nonnenbruch (1942)
The first use of “nephrotictic syndrome” other than in Englishglish ??
Nonnenbruch took over Volhard’s post whenhen thethe latter was dismissed by the Nazisis
The paper which finally broughtught thethe “nephrotic syndrome” into generalneral useuse
This paper was widely quoted during thethe 1950s1950s
Renal biopsy is introduced justjust inin time to re-inforce the conceptept
The term “nephrotic syndrome” becameame generally current around 1950, then:en:
•renal biopsy was introduced 1950--5252
•ultra-thin sections 1956 (Pirani)
•electron microscopy on biopsies 19571957 ((FolliFolli and Kark, Vernier, Farquhar & Good)od)
•silver staining of basement membranerane 19571957 (Jones)
•immunfluorescence on biopsies 1959959 ((KarkKark))
-all permitting a better understandingg ofof glomerular ultrastructure and pathologylogy