Nishi Shinichi, Imai Naofumi, Saito Takao, Ueno Mitsuhiro, Arakawa Masaaki, Oota Takashi, Gejyo Fumitake
Blood Purification Center, Niigata University Medical and Dental Hospital, Niigata, 951-8520, Japan
Clin Exp Nephrol. 2008 Dec;12(6):518-21. doi: 10.1007/s10157-008-0087-9. Epub 2008 Oct 15.
We report here unique electron microscopy findings showing clusters of deposition of spherical and tubular microparticles in a glomerular basement membrane (GBM) of a 46-year-old Japanese male with membranous nephropathy. Another distinct feature was the deep infolding of podocyte membranes into the GBM. Light microscopy showed the ladder formation of the GBM suggesting membranous nephropathy, while the immunofluorescent examination was atypical for the absence of the global capillary deposition of IgG and C3. He had mild liver dysfunction with positive hepatitis B antigen. Antibodies to hepatitis B surface antigen reacted weakly on the GBM in the immunohistochemistry. We suspected the unique findings of this case might be related to the hepatitis B viral infection.
我们在此报告独特的电子显微镜检查结果，显示在一名患有膜性肾病的46岁日本男性的肾小球基底膜（GBM）中存在球形和管状微粒的沉积簇。另一个显著特征是足细胞膜向GBM内深陷。光学显微镜显示GBM呈阶梯状形成，提示膜性肾病，而免疫荧光检查因缺乏IgG和C3的全毛细血管沉积而不典型。他有轻度肝功能障碍且乙肝抗原呈阳性。乙肝表面抗原抗体在免疫组织化学中与GBM反应较弱。我们怀疑该病例的独特发现可能与乙肝病毒感染有关。
