Kai Hirayasu, Shimizu Yoshio, Hagiwara Masahiro, Yoh Keigyou, Hirayama Kouichi, Yamagata Kunihiro, Ohba Shoji, Nagata Michio, Koyama Akio
Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba City, Ibaraki, Japan.
J Nephrol. 2006 Mar-Apr;19(2):215-9.
A 48-year-old male developed massive proteinuria and renal dysfunction after pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA) infection. Examination of a renal biopsy specimen by light microscopy showed severe mesangiocapillary proliferative glomerulonephritis with fibrocellular crescents. Immunofluorescence microscopy showed weak linear staining for immunoglobulin G (IgG), while both the peripheral and mesangial lesions stained for IgA and C3. Immunostaining for a possible antigen related to post-MRSA infection glomerulonephritis, using monoclonal antibody S1D6, revealed marked deposition of S.aureus cell envelope antigen in the glomeruli. Electron-dense deposits were observed in both the subendothelial and the mesangial areas. Focal subendothelial widening accompanied with monocytes or foam cell infiltration was also seen. The findings reflect a typical post-MRSA infection glomerulonephritis caused by S.aureus cell envelope antigen.
一名48岁男性在耐甲氧西林金黄色葡萄球菌（MRSA）感染引起的肺炎后出现大量蛋白尿和肾功能不全。光镜检查肾活检标本显示严重的系膜毛细血管增生性肾小球肾炎伴纤维细胞性新月体形成。免疫荧光显微镜检查显示免疫球蛋白G（IgG）呈弱阳性线性染色，而外周和系膜病变均有IgA和C3染色。使用单克隆抗体S1D6对与MRSA感染后肾小球肾炎相关的可能抗原进行免疫染色，结果显示金黄色葡萄球菌细胞壁抗原在肾小球中有明显沉积。在内皮下和系膜区域均观察到电子致密沉积物。还可见局灶性内皮下增宽伴单核细胞或泡沫细胞浸润。这些发现反映了由金黄色葡萄球菌细胞壁抗原引起的典型的MRSA感染后肾小球肾炎。
