PATHOLOGY AND PATHOGENESIS OF CHRONIC LEAD NEPHROPATHY OCCURRING IN QUEENSLAND
PATHOLOGY AND PATHOGENESIS OF CHRONIC LEAD NEPHROPATHY OCCURRING IN QUEENSLAND
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DOI：
10.1002/path.1711240202
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发表时间：
1978-01-01
影响因子：
7.3
通讯作者：
EMMERSON, BT
中科院分区：
文献类型：
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作者：
INGLIS, JA;HENDERSON, DA;EMMERSON, BT
在昆士兰州[澳大利亚]，许多遭受急性铅中毒的儿童最终死于肾脏收缩。在大多数情况下，肾脏呈颗粒状，并在显微镜下显示纤维化、高血压血管变化和变应性肾小球炎。在这些患者中，高血压和慢性肾功能不全总是先于死亡，通常是由于尿毒症。在少数病例中，肾脏表现出良性高血压的变化，但异常小;纤维化和变应性肾小球炎不存在。临床上，这些患者有高血压，但最低限度的肾功能不全和死亡通常是由于脑出血。铅中毒时，铅可能通过高血压以外的机制对肾脏造成严重损害。假定的事件序列包括儿童期铅中毒时肾小球破坏伴严重肾损伤，儿童期和青少年期被破坏的组织消失，青少年期或成年早期高血压发作，慢性尿毒症逐渐发作和进展，在此期间纤维化和颗粒性发展。在较轻的情况下，由于肾功能仍然足够，因此序列不完整。
Many children who suffered acute Pb poisoning in Queensland [Australia] eventually died with contracted kidneys. In most cases the kidneys were granular and showed microscopically fibrosis, hypertensive vascular changes and alterative glomerulitis. Clinically in these patients, hypertension and chronic renal insufficiency had always preceded death which was usually due to uremia. In a minority of cases the kidneys showed the changes of benign hypertension but were unusually small; fibrosis and alterative glomerulitis were not present. Clinically these patients had had hypertension but minimal renal insufficiency and death was usually due to cerebral hemorrhage. Pb probably caused severe damage to the kidney at the time of the Pb intoxication by some mechanism other than hypertension. The sequence of events postulated comprises severe renal damage with destruction of glomeruli during childhood Pb poisoning, disappearance of the destroyed tissue during childhood and adolescence, onset of hypertension in adolescence or early adult life, gradual onset and progress of chronic uremia during which fibrosis and granularity developed. In milder cases the sequence is not complete because renal function has remained adequate.