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Fifteen patients with evidence of acute poststreptococcal glomerulonephritis were asked about their contact with vapours of organic solvents. Six patients reported brief exposure shortly before the onset of glomerulonephritis, 4 fairly long exposure, and 5 none or insignificant. At the latest followup, 3 of 4 patients who were still exposed to such solvents had proteinuria and a low glomerular filtration rate (GFR), and 2 were hypertensive. Of the 11 patients who had never been or were no longer exposed, the GFR was insignificantly decreased in 2, none had proteinuria and none were hypertensive. Fifteen age-and sex-matched controls, who had been infected with group A beta-hemolytic streptococci, T type 12, had not been exposed, or the exposure was insignificant and not related to the streptococcal infection. Exposure to organic solvents or other nephrotoxic agents may be the condition which determines the outcome of an infection with nephritogenic streptococci.

A man and his daughter had acute glomerulonephritis, the daughter eight years after the father. Both were exposed to vapours of organic solvents shortly before the onset of nephritis.

Fifty patients with biopsy-proven glomerulonephritis and 100 sex- and age-matched controls (50 patients each with non-glomerular renal disease or acute appendicitis) were asked by questionnaire and a telephone interview whether they had been exposed to organic solvents. The questioning and the evaluation of the exposure, if any, was made without knowing the diagnosis of the interviewee. Fifty per cent of the patients with glomerulonephritis reported more than slight exposure, but only 20% of the controls. Exposure to organic solvents may often play a role in the causation of glomerulonephritis.

Nine patients with various types of severe glomerulonephritis were treated with drainage of the thoracic duct (n=8) and/or plasmapheresis (n=6) without the use of pharmacological immunosuppression. In most of the patients treatment produced a prompt temporary regression of albuminuria and creatininemia. In one patient renal function was substantially improved 8 months after the last period of treatment, in 2 patients the progress of the uremia was probably retarded. In the remaining 6 patients treatment had no obvious effect on the course of the illness. Drainage of the thoracic duct and plasmapheresis may be of benefit in the treatment of glomerulonephritis, but their proper utilization requires further studies.