Abstract
Clinical, epidemiological, morphological and immunopathological aspects of malaria-associated nephropathy were discussed, with special emphasis on immunological investigations. Immunofluorescence studies on renal biopsies from patients with the nephrotic syndrome and P. malariae parasitaemia have shown the presence of IgG and certain complement components on glomerular basement membranes (GBM). IgG with anti-P. malariae specificity was found in eluates of kidney tissues from such patients and P. malariae antigen was identified in the GBM by immunofluorescence studies employing human antiserum to P. malariae. These observations are compatible with the concept that the nephropathy associated with P. malariae infections is a form of immune-complex nephritis initiated by circulating P. malariae antigen(s) and anti-P. malariae antibodies. This concept is supported by electron microscope studies showing electron-dense material associated with the GBM of certain diseased kidneys in which immune complexes had been detected in glomeruli by immunofluorescence. The concept of malaria-associated renal disease as a form of immune-complex disease should be useful in developing new approaches to research on the pathogenesis of both the initiating and the perpetuating immunopathological lesion. The meeting considered a detailed series of research recommendations consisting primarily of immunological experiments relating to pathophysiology. [These were too detailed and lengthy for publication in this report, but they may be obtained by writing directly to Immunology, World Health Organization, Avenue Appia, 1211 Geneva, Switzerland.]