Wehner H, Gärtner H V
Virchows Arch A Pathol Anat Histol. 1977 Sep 28;375(3):211-23. doi: 10.1007/BF01102989.
Immunohistological study of 123 kidney biopsies of non-glomerulonephritic kidney diseases showed that deposits of immunoglobulins are found more often in cases of malignant than in cases of benign nephrosclerosis. Primary malignant nephrosclerosis is mostly associated with glomerular deposits of immunoglobulins. Positive immunohistological findings are frequent in cases of diabetic glomerulosclerosis, mainly within glomeruli, but also in tubular basement membranes and Bowman's capsule. In cases of glomerular amyloidosis we see cloudy-bandlike deposits, but are unable to differentiate cases with or without the nephrotic syndrome. If we consider an immunopathogenetic mechanism for the diseases discussed in terms of the present findings, it seems possible for primary malignant nephrosclerosis as well as for certain glomerular changes associated with acute renal failure or rejection of transplants. In diabetic glomerulosclerosis (apart from special forms with perimembranous lesions) and glomerular amyloidosis, we consider such a mechanism to be unlikely. By separating the non-glomerulonephritic diseases into different types of deposits we found pictures that correspond with immunocomplex diseases. Pictures resembling anti-basement membrane diseases have not been seen. Characteristic patterns of deposits were not found, thus immunohistology is without additional diagnostic value in the field of non-glomerulonephritis disease.
对123例非肾小球性肾病肾活检的免疫组织学研究表明，与良性肾硬化相比，免疫球蛋白沉积在恶性病例中更常见。原发性恶性肾硬化主要与肾小球免疫球蛋白沉积有关。糖尿病肾小球硬化病例中免疫组织学阳性结果很常见，主要在肾小球内，但也见于肾小管基底膜和鲍曼囊。在肾小球淀粉样变性病例中，我们看到云雾状带状沉积，但无法区分有无肾病综合征的病例。从目前的研究结果来看，如果我们考虑所讨论疾病的免疫发病机制，原发性恶性肾硬化以及某些与急性肾衰竭或移植排斥相关的肾小球变化似乎都有可能。在糖尿病肾小球硬化（除了有膜周病变的特殊形式）和肾小球淀粉样变性中，我们认为这种机制不太可能。通过将非肾小球性疾病分为不同类型的沉积物，我们发现了与免疫复合物疾病相符的情况。未见到类似抗基底膜疾病的情况。未发现特征性的沉积模式，因此免疫组织学在非肾小球肾炎疾病领域没有额外的诊断价值。
