Glomerular focal nephritis (cavity) I33.0+N08.8

Max Hermann Friedrich Löhlein (1877 - 1921) from Leipzig wrote a paper in 1907 in which he described for the first time the Löhlein nephritis named after him in the context of infective endocarditis. This had already been described by Harbitz in 1899 and called a "hemorrhagic nephritis" (Sebastian 2018).

Glomerular focal nephritis is an embolic nephritis that is one of the hematogenous renal diseases (Baron v. Koranyi 1929). It results from bacterial microthrombi in the context of a severe systemic infection (Buchta 2004).

In the setting of infective endocarditis, immune complex deposition can lead to renal involvement on the glomerular basement membrane (Kasper 2015) with:

- proteinuria

- hematuria

- glomerular focal nephritis (almost regularly present)

- renal infarcts in embolic events

- acute diffuse glomerulonephritis (rarely present) (Herold 2022)

Glomerular focal nephritis occurs in approximately 2.3% of patients with infective endocarditis (Girndt 2023). In patients with systemic polyarteritis nodosa, renal involvement is found in up to 70%, some of which present as glomerular herd nephritis (Altmeyer 2007).

Glomerular focal nephritis occurs in the setting of severe systemic infections such as:

- infective endocarditis (Girndt 2023)

- endocarditis lenta (special form of infective endocarditis [Greten 2010])

- systemic polyarteritis nodosa (Altmeyer 2007)

Systemic infection may result in the formation of bacterial microemboli and immune complexes. These attach focally to the glomerular basement membrane and lead to glomerular focal nephritis (Tasar 1990).

In addition to the symptoms of the causative disease, there is:

- hematuria

- proteinuria (Buchta 2004)

- Hematuria

- Proteinuria (Klotz 2013)

Homogeneous eosin red fibrinoid necrosis can be seen in individual glomerulus loops (Thomas 2004).

Therapy is determined by the underlying disease (Baron v. Koranyi 1929).

Glomerular herd nephritis is one of the benign diseases. The prognosis is determined by the causative disease (Baron v. Koranyi 1929).

1. Altmeyer P, Paech V, Dickel H, Stücker M, Jackowski J, Kreuter A, Gambichler T (2007) Dermatologic differential diagnosis: the path to clinical diagnosis. Springer Medicine Berlin / Heidelberg 665
2. Buchta M, Höper D W, Sönnichsen A (2004) The second StEx: basic knowledge clinical medicine for exams and practice. Springer Verlag Heidelberg / Berlin / New York 25, 478
3. Girndt M, Michl P (2023) Internal medicine high 2. Elsevier Urban and Fischer Publishers Germany 360.
4. Greten H, Rinninger F, Greten T (2010) Internal medicine. Georg Thieme Verlag Stuttgart 287
5. Herold G et al (2022) Internal medicine. Herold Publishers 161
6. Kasper D L, Fauci A S, Hauser S L, Longo D L, Jameson J L, Loscalzo J et al (2015) Harrison's Principles of Internal Medicine. Mc Graw Hill Education
7. Endocarditis: 820, 1837 ????
8. Klotz T, Zafari A M, Schupp M (2013) Internal medicine in question and answer: questions and case histories. Elsevier Urban and Fischer Publishers Munich 43
9. Baron v. Koranyi A (1929) Lectures on functional pathology and therapy of renal diseases. Julius Springer Verlag Berlin 225
10. Sebastian A (2018) A Dictionary of the History of Medicine. Informa Healthcare Publishers London
11. Tasar R (1990) The influence of infective endocarditis on the release of vasoactive substances and inflammatory mediators during cardiac surgery with heart-lung machine. Dissertation for the degree of doctor medicinae (Dr. med.), submitted to the Friedrich- Schiller- University Jena.
12. Thomas C, Büttner R, Hagedorn M, Moll R, Ramaswamy A, Rüschoff J (2004) Histopathology compact: course book of general and special histopathology. Schattauer Verlag Germany 103