Tonsils are one of the living organs of human immunity. They can produce lymphocytes and antibodies against the invading bacteria and viruses directly, just like a guard of armed police guarding the frontier defense fortress in the human body in contact with the outside world.
A comprehensive assessment of lymphocyte function and disease in patients with nephropathy is required before tonsillectomy:
Tonsils can produce antibodies and lymphocytes that have protective effects on the human body and act as the body's first line of defense. However, if the immune response is excessive, it can also trigger a local and systemic inflammatory reaction, thereby exacerbating kidney disease. So we can consider removing tonsillitis from frequent episodes; if it happens occasionally or not, this small gland is still a treasure to the human body, and its protective effect on the body is far greater than the damage caused by inflammation. It's a pity to remove it.
The tonsil shrinks gradually with age, and its function declines, so some children or adolescents with tonsillar enlargement may as well wait to see if there are repeated inflammatory reactions after the atrophy. If the frequency of tonsillitis attacks decreases with age, it can be postponed.
Of the numerous nephropathy, only patients with repeated gross hematuria and acute streptococcal post-infection nephritis in IgA nephropathy are closely associated with tonsillitis, while other types of nephritis are only affected by local inflammation. It is not clear causality. Therefore, in the case of common nephropathy, blind tonsillectomy does more harm than good.
Tonsillectomy is not an etiological treatment, but a temporary solution to the trigger link that causes local inflammation and cannot replace other treatments for nephropathy (immunomodulation, regulation of kidney workload, hypotension, etc.)
Some patients experience a temporary exacerbation within a week after tonsillectomy, such as a marked increase in gross hematuria or proteinuria, which is a good thing for the vast majority of patients with tonsillar nephritis. There may be some association between tonsil and nephropathy. Tonsillectomy is beneficial to the improvement of the disease and the reduction of the number of relapses of nephropathy. The relief of the above symptoms does not exceed 3 months after surgery. There is no need for overtreatment at this stage. Pay attention to reduce local irritation (spicy food, cold air) can.
The symptoms of pharyngitis in some patients after tonsillectomy were aggravated, which was prominent in the increase of lymphoid follicles in the posterior wall of pharynx, suggesting that this part of patients belonged to hyperfunction of the lymphoid system, and removing tonsils did not help to alleviate the disease.