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January 14, 1899


JAMA. 1899;XXXII(2):85-86. doi:10.1001/jama.1899.02450290035007

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The frequency with which albumin appears in the urine of children makes it imperative that some classification as regards its significance, its influence on diagnosis, and especially on prognosis, be made. The division into primary and secondary albuminuria is merely a cloak to hide our ignorance, for the diseases in which primary albuminuria or albuminuria with definite and marked renal changes (Tirard) occurs, may not infrequently instead be accompanied by the so-called secondary albuminuria, or albuminuria in which the subsequent course of the disease leads us to infer that the renal changes were of the most trivial character. Thus, the albuminuria occurring so commonly in scarlet fever and diphtheria, we are accustomed to regard as primary, because there is commonly an acute nephritis or, more correctly speaking, a glomerulo - nephritis which, postmortem, is plainly evident, or, if the case progresses to a favorable termination, is followed by symptoms of subacute

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