Collan Y, Lähdevirta J, Jokinen E J
Virchows Arch A Pathol Anat Histol. 1978 Feb 10;377(2):129-44. doi: 10.1007/BF00427001.
Electron microscopical changes in the glomeruli in 20 kidney biopsies from 18 patients, who were suffering from or had lately suffered from Nephropathia epidemica were studied. Various kinds of deposits were seen. Under the endothelial cells there were collections of light flocculent material. Small dark deposits were seen in the mesangium at the mesangial cell processes, inside the thickened basement membrane, and occasionally on the epithelial side of the membrane. Large deposits were seen around mesangial cells in the mesangium. Deposits were less numerous than in chronic immune complex diseases. The intramembranous or subepithelial deposits were associated with "moon craters", membranous convoluted structures or membrane debris. Granular extracellular mesangial material, round extracellular particles and intraendothelial microtubular inclusions were occasionally seen. In two of our cases occasional capsular epithelial cells showed numerous myelin bodies. Typical viruses were not seen in the glomeruli. The findings are in accord with the short period of scanty immune complex deposition in the glomeruli in the clinically active phase of Nephropathia epidemica.
对18例患有或近期患流行性肾病患者的20份肾脏活检标本中的肾小球进行了电子显微镜检查，观察到了各种沉积物。在内皮细胞下可见轻度絮状物质聚集。在系膜细胞突起处的系膜、增厚的基底膜内以及偶尔在膜的上皮侧可见小的深色沉积物。在系膜中的系膜细胞周围可见大的沉积物。沉积物的数量比慢性免疫复合物疾病少。膜内或上皮下沉积物与“火山口”、膜性卷曲结构或膜碎片有关。偶尔可见颗粒状细胞外系膜物质、圆形细胞外颗粒和内皮内微管内含物。在我们的两例病例中，偶尔可见包膜上皮细胞有大量髓鞘小体。在肾小球中未见到典型病毒。这些发现与流行性肾病临床活动期肾小球内免疫复合物沉积时间短且数量少相符。
