Mohácsi G, Mágori A, Ormos J, Abrahám G, Pokorny G, Sonkodi S
I. sz. Belgyógyászati Klinika, Szent-Györgyi Albert Orvostudományi Egyetem, Szeged.
Orv Hetil. 1991 Jan 20;132(3):115-9.
Following 689 percutaneous renal biopsies, membranous glomerulonephritis was proved in 68 patients. In 16 (23.5%) an underlying primary disease was verified, and thus the glomerulonephritis the secondary form. The primary disease was SLE in 5 cases, diabetes mellitus in 5 cases, rheumatoid arthritis in 3 cases, chronic active hepatitis in 2 cases, an ulcerative colitis and eosinophilic angiolymphoid hyperplasia in 1 patient. As initial sign, nephrotic syndrome emerged in 87.5% of the 16 cases. Microscopic haematuria was observed in half of the patients, as was hypertension, while acute renal failure presented in only 1 case. Histologically, in 13 cases the predominance of early glomerular alterations was characteristic, while in 9 cases the picture proved to be equivocal and accompanied by some degree of interstitial alterations. During combined treatment, remission was achieved in 75%. Two patients with SLE died, but not as a consequence of renal failure. Transient side-effects of the treatment were registered in 5 cases. The principal pathogenetic and clinical differences between the individual secondary nephritis forms, and the difficulty of their differentiation from the idiopathic cases, even on repeated examination, are emphasized. In 3 patients the possibility of secondary renal processes was suggested by the histological picture, and this was proved by the detailed clinical findings.
在689例经皮肾活检中，68例被证实为膜性肾小球肾炎。其中16例（23.5%）证实存在潜在的原发性疾病，因此该肾小球肾炎为继发性。原发性疾病中，系统性红斑狼疮5例，糖尿病5例，类风湿关节炎3例，慢性活动性肝炎2例，溃疡性结肠炎和嗜酸性血管淋巴样增生各1例。16例中有87.5%以肾病综合征为首发症状。半数患者有镜下血尿，高血压患者也占半数，而急性肾衰竭仅1例。组织学上，13例以早期肾小球改变为主，9例表现不明确且伴有一定程度的间质改变。联合治疗期间，75%的患者病情缓解。2例系统性红斑狼疮患者死亡，但并非死于肾衰竭。5例出现治疗的短暂副作用。强调了各继发性肾炎形式之间主要的发病机制和临床差异，以及即使经过反复检查，将它们与特发性病例区分开来的困难。3例患者的组织学表现提示可能存在继发性肾脏病变，详细的临床检查结果证实了这一点。
