Renal Morphologic Lesions Reminiscent of Diabetic Nephropathy
Renal Morphologic Lesions Reminiscent of Diabetic Nephropathy
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DOI：
10.5858/arpa.2012-0243-ra
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发表时间：
2013-03-01
影响因子：
4.6
通讯作者：
Kanwar, Yashpal S.
中科院分区：
文献类型：
--
作者：
Raparia, Kirtee;Usman, Irtaza;Kanwar, Yashpal S.
研究背景：糖尿病肾病中常见的结节状、毛细血管间肾小球硬化性病变，类似于金梅尔斯蒂尔-威尔逊结节，也可见于无任何临床病史或糖尿病证据的患者。目的：讨论糖尿病肾病病变的病理生物学，包括轻链沉积性疾病、淀粉样变性、免疫乳突性肾病、膜增生型肾小球肾炎和特发性结节状肾小球硬化，以及如何将它们与糖尿病肾病进行鉴别。资料来源：已发表的文献和作者的个人经验。结论--结构良好的毛细血管间、结节状系膜病变，以及增厚的肾小球基底膜和管状基底膜，以及肺透明膜实际上是糖尿病肾病的病理性病变。然而，病理学家必须通过对组织切片、免疫荧光和电子显微镜进行特殊染色来排除糖尿病肾病的病变。
Context.-Nodular, intercapillary glomerulosclerotic lesions resembling Kimmelstiel-Wilson nodules commonly observed in diabetic nephropathy can also be seen in patients without any clinical history or evidence of diabetes.Objectives.-To discuss the pathobiology of lesions reminiscent of diabetes nephropathy, including light-chain deposition disease, amyloidosis, immunotactoid nephropathy, the membranoproliferative form of glomerulonephritis, and idiopathic nodular glomerulosclerosis, and how to differentiate them from diabetic nephropathy.Data Sources.-Published literature and authors' personal experience.Conclusions.-The well-formed, intercapillary, nodular mesangial lesions, along with thickened glomerular basement membranes and tubular basement membranes, and hyaline arteriolosclerosis are virtually pathognomic of diabetic nephropathy. However, the pathologist must exclude lesions reminiscent of diabetic nephropathy by performing special stains on histologic sections, immunofluorescence, and electron microscopic studies.