Congenital syphilis and glomerulonephritis with evidence for immune pathogenesis.

In 3 infants with congenital syphilis the dominant clinical manifestation of syphilitic kidney disease was the nephrotic syndrome. Mesangioendothelial proliferation was present in 2 cases and mixed proliferative glomerulonephritis with crescent formation in the third. The severity of the clinical and histopathological abnormalities could be related to the apparent duration of the illness. In all 3 cases immune complex deposition could be shown within and along the epithelial aspect of the glomerular basement membrane on light, electron, and immunofluorescent microscopy. These features, together with a reduced total serum haemolytic complement, suggest an immune pathogenesis of the glomerulonephritis associated with early congenital syphilis.