塞内加尔病因不明的“局部性肾病”和“热带性膜性肾小球肾炎”

Morel-Maroger L, Saimot A G, Sloper J C, Woodrow D F, Adam C, Niang I, Payet M

Br Med J. 1975 Mar 8;1(5957):541-6. doi: 10.1136/bmj.1.5957.541.

A study of renal biopsy specimens obtained in Senegal from 24 children and six adults with nephrotic syndrome showed two unusual varieties of nephropathy--namely, an extramembranous glomerulonephritis associated with hypocomplementaemia (four cases), a combination previously described only in systemic lupus erythematosus, and a "tropical nephropathy" (16 cases). The latter, though lacking the diffuse glomerular deposits of immunoglobulin described in quartan malarial nephropathy (Q.M.N.), showed a curious progressive and segmental glomerulosclerosis, characterized by a "flaking" or fibrillary splitting of the glomerular capillary wall, seen in Q.M.N. Serological evidence of malaria was lacking in a third of the childhood cases.

一项针对塞内加尔24名儿童和6名成人肾病综合征患者肾活检标本的研究显示，存在两种不寻常的肾病类型——即伴有低补体血症的膜外肾小球肾炎（4例），这种组合此前仅在系统性红斑狼疮中有所描述，以及“热带肾病”（16例）。后者虽没有三日疟肾病（Q.M.N.）中描述的弥漫性肾小球免疫球蛋白沉积，但显示出一种奇特的进行性节段性肾小球硬化，其特征为肾小球毛细血管壁出现“片状剥落”或纤维状分裂，这在三日疟肾病中也可见到。三分之一的儿童病例缺乏疟疾的血清学证据。