Pathogenesis of heroin-associated glomerulonephritis - Correlation betweenthe inflammatory activity and renal deposits of immunoglobulin and complement?

Renal specimens from 19 autopsies of persons known to be intravenous heroin -addicts and with severe lympho-monocytic glomerulonephritis were investiga ted to correlate the inflammatory activity and deposits of immunoglobulin a nd complex ment. In all sections, there were 10 or more LCA-positive cells/ glomerulum, counted in 20 glomerula but only up to 3 LCA-positive cells in a control-group of 10 autopsied persons without drug addiction and any rena l diseases. In some cases diffuse granular deposits of immunoglobulin were found together with deposits of Clq. Although these changes cannot be demon strated in all cases, deposits of Clq point to an activation of the classic al way of the complement binding system in heroin-associated glomerulonephr itis. The underlying process, activation of the complement binding system b y heroin/morphin itself and adulterants or by hepatitis B and C infection, which are frequent in heroin-addicts, is still unclear. (C) 2000 Elsevier S cience Ireland Ltd. All rights reserved.