McPhaul J J
Annu Rev Med. 1977;28:37-42. doi: 10.1146/annurev.me.28.020177.000345.
In summary, IgA-associated glomerulonephritis is an interesting clinical problem. The immunohistochemical identification of renal IgA deposits is the sine qua non of its diagnosis, although most of the patients reported have had hematuric syndromes, particularly recurrent gross hematuria. The importance of this immunopathologic entity devolves from the crucial use of special stains to identify IgA, the enigmatic role of IgA, the usual mesangioapthic expression of histologic response, and the ill-defined relationship of this clinical problem to nephropathies associated with systemic diseases that also have glomerular IgA deposits. Although still unproven, it is likely that the usual instance of IgA-associated glomerulonephritis is due to deposition of circulating immune complexes containing IgA. The nature of the exciting antigen(s), quantitative measures and characteristics of such complexes, and the role of mediating systems, including coagulation, have not yet been elucidated.
总之,IgA相关性肾小球肾炎是一个有趣的临床问题。肾脏IgA沉积物的免疫组化鉴定是其诊断的必要条件,尽管大多数报道的患者有血尿综合征,尤其是复发性肉眼血尿。这种免疫病理实体的重要性源于使用特殊染色剂鉴定IgA的关键作用、IgA的神秘作用、组织学反应通常的系膜病变表现,以及这个临床问题与同样有肾小球IgA沉积物的系统性疾病相关肾病之间不明确的关系。虽然尚未得到证实,但IgA相关性肾小球肾炎的常见情况可能是由于含有IgA的循环免疫复合物沉积所致。激发抗原的性质、此类复合物的定量测量和特征,以及包括凝血在内的介导系统的作用尚未阐明。