A problem of fundamental importance in the clinical study of any form of Bright's disease is a consideration of the length of time the patient has been observed. This is particularly true in the study of lipoid nephrosis because a diagnosis cannot be made with any degree of certainty without a long period of observation. Too often a patient is studied during one stage of the disease, and the signs and symptoms observed in this brief period are considered to constitute the true picture of the renal disorder. In chronic glomerulonephritis the variability of the clinical features often leads to confusion in their proper interpretation. At one time all the major symptoms—albuminuria, edema, hypertension, nitrogen retention and occasionally a convulsion—may be present. Later, hypertension and nitrogen retention may disappear, and albuminuria and edema may be so pronounced that lipoid nephrosis is thought to exist. At another stage of the disease
MURPHY FD, WARFIELD LM, GRILL J, ANNIS ER. LIPOID NEPHROSIS: A STUDY OF NINE PATIENTS, WITH SPECIAL REFERENCE TO THOSE OBSERVED OVER A LONG PERIOD. Arch Intern Med (Chic). 1938;62(3):355–376. doi:10.1001/archinte.1938.00180140002001
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