Stanley E. H Brooks

Effacement of glomerular foot processes in kwashiorkor

In a study of the pathogenesis of the oedema of kwashiorkor the ultrastructure of the kidneys from 6 children was examined shortly after they died from oedematous malnutrition. There was a generalised effacement of the glomerular epithelial cells onto the basement membrane. The filtration slits that remained were narrowed. The picture was similar to that seen in minimal-change nephrotic syndrome--but none of the children had albuminuria. The degree of effacement was statistically related to treatment with gentamicin. The findings suggest that there is a defect in the anionic charge of the glomerular basement membrane in oedematous malnutrition, that the membrane charge is more easily neutralised by cations such as gentamicin, and that, because proteinuria is not a feature of oedematous malnutrition, the proteinuria in other conditions associated with glomerular epithelial cell effacement (eg, minimal-change nephrotic syndrome) is due to something more complex than simple loss of charge.

Electron microscopy of giardia lamblia in human jejunal biopsies

Summary A description is given of the ultrastructure of Giardia lamblia found in three jejunal biopsies from children. The unique median body, vacuoles and cytoplasmic clefts of this protozoon are illustrated. No evidence of penetration of the trophozoite into the jejunal mucosa or deeper tissues is demonstrable. This work was supported in part by a Grant from the Wellcome Trust to one of the authors (S. E. H. B.).