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The appearance of 2 diseases is often coincidental but when the association is frequent a relationship may be suspected. Comaish and Kerr1 call attention to the failure of dermatologic treatises and communications dealing with erythema multiforme to mention an associated renal involvement. Some authors mention concomitant renal disease only to deny any relationship, although it was suspected by Osler as early as 1888.
In the Comaish and Kerr's series of 5 patients albuminuria, hematuria, an elevated blood urea level, and an increased sedimentation rate were observed. Each of 3 patients exhibited edema, cylindruria, and a reversal of the albumin-globulin ratio. One had dysuria and bacilluria, and one had an elevated blood pressure. None had pyuria. Two patients died. A renal biopsy of one patient showed glomerular damage and an autopsy of another patient showed glomerular damage and acute tubular necrosis. The latter was attributed to a terminal staphylococcal infection.
ERYTHEMA MULTIFORME AND THE KIDNEYS. JAMA. 1962;179(12):960–961. doi:10.1001/jama.1962.03050120038010
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