Cereal Grain Proteins
Gluten and Kidney Disease
The nephrotic syndrome involves increased glomerular excretion of protein. Gabordi et al reported a 6- year-old girl with gluten allergy expressed as celiac disease and dermatitis herpetiformis who developed the nephrotic syndrome. Elimination of gluten grains resolved all three major manifestations of gluten allergy.
Sandberg et al reported on 6 patients who experienced remission of nephrotic syndrome when milk was eliminated from their diet and exacerbation when it was reintroduced. Six patients in a study of 17 children with steroid resistant nephrotic syndrome responded to milk exclusion with remission of proteinuria in 3-8 days. Four of the six improved patients had other manifestations of food allergy including recurrent bronchitis, atopic dermatitis, and gastrointestinal disturbances.
Ferri et al stated that 'dietary macromolecular antigens can be involved in the pathogenesis of IgA nephropathy (IgAN), the effect of a low-antigen-content diet was evaluated in 21 patients with immunohistochemical findings of active IgAN. The diet was followed for a 14-24-week period. In all cases the effects of the treatment were evaluated by clinical and serological parameters, and in 11 patients also by repeat renal biopsy. After dietetic therapy a significant reduction of urinary proteins was recorded. Heavy proteinuria present in 12 cases during the 6 months preceding the treatment, was markedly reduced or disappeared in 11. (see abstract) Sato et al reported: "... that food antigens participate strongly in the pathogenesis of some patients with IgA nephropathy."
McCrory et al reported: "... the occurrence of immune complex glomerulonephritis in a patient with eosinophilic gastroenteritis and food hypersensitivity. Renal biopsy revealed immune complex glomerulonephritis with bovine serum albumin (BSA), immunoglobulins M and G and complement deposited focally in the glomerular basement membrane. With strict dietary limitation of identified causative antigens and prednisone therapy, CIC levels decreased to 16,000 micrograms/dl and serum BSA antibody hemagglutinating titer fell 32-fold over a period of 15 months. There was prompt symptomatic relief and amelioration of signs of nephritis. Recognition of food antigens to which the patient was hypersensitive provided a rationale for the relief of the gastrointestinal disturbance, growth stunting, and renal disease.
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