Nagy J, Magyarlaki T, Háber A, Kun L, Bohle A
2nd Department of Medicine, University Medical School, Pécs, Hungary.
Acta Morphol Hung. 1991;39(4):299-307.
The authors have found morphological alterations identical with hyperfiltration glomerular injury in the renal biopsies of 23 out of 100 patients with IgA nephropathy. In 15 of them the lesions were similar to the different stages of segmental glomerular hyalinosis and sclerosis with deposition of IgM and C3. At the time of renal biopsy, the serum creatinine of all except 8 patients was normal (maximally 170 mumol/1), only 13 had hypertension, and all except 2 were proteinuric. During the follow-up period (mean +/- 2Sd = 138 +/- 76 months) all of them became hypertensive. In 10 patients end-stage renal failure developed, and in another 10, serum creatinine also became elevated (range 124 - 504 mumol/1). On the basis of these data the development of focal segmental hyalinosis and sclerosis should be interpreted as a bad prognostic sign in IgA nephropathy.
作者在100例IgA肾病患者中的23例肾活检中发现了与超滤性肾小球损伤相同的形态学改变。其中15例病变类似于节段性肾小球玻璃样变和硬化的不同阶段，并伴有IgM和C3沉积。在肾活检时，除8例患者外，所有患者的血清肌酐均正常（最高170μmol/L），只有13例有高血压，除2例外均有蛋白尿。在随访期间（平均±2标准差=138±76个月），所有患者均出现高血压。10例患者发展为终末期肾衰竭，另有10例患者血清肌酐也升高（范围为124 - 504μmol/L）。基于这些数据，局灶节段性玻璃样变和硬化的发生应被视为IgA肾病预后不良的标志。
