Clinical Study of Tonsillar Provocation Test for Glomerulo-Nephritis

Tonsillitis is well known as a predisposing factor to nephritis. We performed provocation tests using an ultra-short wave indirect irradiation method in 64 patients with nephritis in which a focus of infection was suspected, and the clinical usefulness of the tonsil provocation test was assessed. All the patients underwent tonsillar stimulation by ultra-short wave indirect irradiation. Thirty-five of the 64 patients were positive and 29 negative. We monitored the patient's course and compared the rate of improvement in the 27 patients who underwent tonsillectomy with that in the 37 patients who did not undergo tonsillectomy. Some improvement was observed in the surgically treated patients especially those with IgA nephritis, whether thier tonsillar provocation tests were positive or negative. The results may indicate that tonsillectomy should be actively or constructively performed. We also assessed changes in complement levels at the time of provocation. To determine the post-operative prognosis of tonsillectomy. C₁sub-component, C₁-INH and C_1r-C_1s-C₁-INH complex were measured in 16 patients and again no significant results were demonstrated. As a result, we have shown the problems involved in the tonsil provocation rating criteria, and have stressed the necessity of reassessing the tonsil provocation test.