Nephrotic syndrome associated with osteomyelitis without secondary amyloidosis.

The nephrotic syndrome has been reported as a consequence of amyloidosis secondary to osteomyelitis.1-3This communication describes four patients with a history of osteomyelitis, in whom the nephrotic syndrome subsequently developed. Each patient underwent renal biopsy which revealed membranoproliferative glomerulonephritis without evidence of amyloid deposition in the kidney. Their clinical course and renal biopsy findings add chronic osteomyelitis to the list of infectious diseases known to produce the nephrotic syndrome without secondary amyloidosis. Patient Summaries Patient 1. —A 48-year-old man was hospitalized at Georgetown University Hospital in February 1955 for evaluation of proteinuria of one year's duration and peripheral edema of six months' duration. His history revealed no renal disease but he had a fracture of the left humerus 32 years earlier with open reduction. Acute osteomyelitis subsequently developed and a chronically draining sinus was present for 12 months. There was no recent recurrence of osteomyelitis. Physical examination revealed