We report two patients with methylmalonic acidemia (MMA) in whom renal biopsy demonstrated interstitial nephritis, bringing the total of such reported cases to four. In addition, hypertension, observed in one of our patients, has not been previously reported as the presentation of renal disease in MMA. The etiology of interstitial nephritis in MMA did not appear to be due to urate nephropathy. To date, 15 patients with MMA have been reported with renal complications, including chronic renal failure, making it imperative that children with MMA have their renal status evaluated.
The cell mediated immunity as expressed by 2,4 DNCB skin sensitivity was measured in 50 healthy Iranian orphans of the age from 15 years. Complete records of the development of these children from birth were available. Children with severe gastroenteritis leading to marasmus and temporary thymic atrophy during the first 6 months of life showed a persistent atopy 1-5 years later. Less severe disease during this time lead to hyporesponsiveness. Similar stress after the 6th month of life did not lead to persistent changes in their cell mediated immunity. The implications of this for the epidemiology of neoplasia and infectious disease are discussed.
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