Glomerulonephritis with organized deposits: a new clinicopathological entity? Light-, electron-microscopic and immunofluorescence study of 12 cases.
Glomerulonephritis with organized deposits: a new clinicopathological entity? Light-, electron-microscopic and immunofluorescence study of 12 cases.
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伴有组织沉积物的肾小球肾炎：一种新的临床病理实体？
DOI：
10.1159/000168049
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发表时间：
1990
影响因子：
4.2
通讯作者：
G. Monga
中科院分区：
文献类型：
--
作者：
G. Mazzucco;S. Casanova;U. Donini;C. Rollino;P. Zucchelli;G. Piccoli;G. Monga
本文报告12例无全身性疾病的肾小球肾炎，表现为肾小球内机化沉积物。9例患者中发现微纤维（直径11-30 nm），另外3例患者中发现微管（直径20-35 nm）。淀粉样蛋白的组织化学染色总是阴性。光镜下可见系膜增生型5例，膜性增生型3例，膜性增生型4例。通过免疫荧光，颗粒状沉积物，主要是IgG和C3，发现在所有情况下，无论是在系膜或系膜和毛细血管壁。2例患者进行了第二次活检。透明肾小球数量增加，但肾小球变化的一般模式保持不变。最常见的临床表现为高血压、微量血尿和蛋白尿，常为肾病范围。与文献报道的不同，还发现了2例儿科病例，总体预后（平均随访54.3个月）基本良好。这些结果的诊断相关性指出，但需要进一步的调查，建议一个新的临床病理实体。
Twelve cases of glomerulonephritis in patients without systemic diseases, displaying organized glomerular deposits, were reported. Microfibrils (11-30 nm diameter) were found in 9 patients and microtubules (20-35 nm diameter) in the other 3. Histochemical stainings for amyloid were always negative. By light microscopy, mesangial proliferative, membranous and membranoproliferative patterns were seen in 5, 3 and 4 patients, respectively. By immunofluorescence, granular deposits, mainly of IgG and C3, were found in all cases, either in the mesangium or in the mesangium and in the capillary walls. A second biopsy was performed in 2 patients. The number of hyaline glomeruli was increased, but the general pattern of glomerular changes remained unchanged. The commonest clinical findings were hypertension, microhematuria and proteinuria, often of nephrotic range. At variance to what is reported in the literature, 2 pediatric cases were found as well, and the overall prognosis (mean follow-up 54.3 months) was mostly favorable. The diagnostic relevance of these findings is pointed out, but further investigations are needed, before suggesting a new clinicopathological entity.