Chronische pyelonefritis; een aantal klinische waarnemingen, met een studie van de diagnostische betekenis van antilichamen tegen colibacteriën bij urineweginfecties.

In chapter I a number of important publications concerning chronic pyelonephritis are reviewed. The classical descriptions of the pathology of the disease by Staemmler and Dopheide (1930) and Weiss and Parker (1939) have been supplemented by Kimmelstiel (1961) who considers polymorphonuclear leukocytes in the inflammatory infiltrate as very important for the histological diagnosis. Cotran (1965) is of the opinion, that an infiltrate consisting of plasma-cells can also be regarded as a sign of bacterial inflection. Renal biopsy is only of limited value for the diagnosis of chronic pyelonephritis. In their descriptions of the clinical picture most authors mention the insidious course, the equivocal complaints and physical signs masking the nature of the disease. In spite of the fact that more than half of the patients suffer from hypertension, the nature of the relationship between chronic pyelonephritis and hypertension is not clear... Dejdar and Prat (1958) and Hodson (1959) have described the radiologic picture of chronic pyelonephritis and Lindvall (1960) did the same for papillary necrosis. The differential diagnosis of chronic pyelonephritis vs. papillary necrosis is often difficult and sometimes impossible...