紫癜性肾炎的电子显微镜及免疫组织化学研究

Electron-microscopic and immunohistochemical study in Henoch-Schoenlein nephritis.

作者信息

Wozniak Aldona, Pluta-Hadas Katarzyna, Zurawski Jakub, Janicka-Jedynska Malgorzata, Kaczmarek Elzbieta, Zachwieja Jacek, Idasiak-Piechocka Ilona

机构信息

Department of Clinical Pathomorphology, Karol Marcinkowski University of Medical Sciences, Poznan, Poland.

出版信息

Ultrastruct Pathol. 2013 Feb;37(1):83-92. doi: 10.3109/01913123.2012.670035.

DOI:10.3109/01913123.2012.670035

PMID:23383618

Abstract

Henoch-Schoenlein nephritis (HSN) is the most common secondary childhood nephropathy, leading to end-stage renal disease in up to 20% of pediatric patients after long-term follow-up. Forty-four cases of HSN were reviewed (32 children, 12 adults). Electron microscopy (EM) was performed in 7 cases and immunohistochemistry for Ki-67, PCNA, and p27 in all. Light microscopy: grade II (18), III (15), IV (3), and VI (8). Glomerulosclerosis and interstitial fibrosis were important prognostic markers and coexisted with poor outcome. EM was performed mainly in grade VI and was useful in recognition of early glomerulosclerosis. No correlations were found between the Ki67 and PCNA mesangial expression and outcome. Progressive decrease in p27 podocyte expression was noted with more severe HSN grades.

摘要

过敏性紫癜性肾炎（HSN）是儿童最常见的继发性肾病，经过长期随访，高达20%的儿科患者会发展为终末期肾病。回顾了44例HSN病例（32例儿童，12例成人）。对7例进行了电子显微镜检查（EM），对所有病例均进行了Ki-67、增殖细胞核抗原（PCNA）和p27的免疫组织化学检查。光镜检查：II级（18例）、III级（15例）、IV级（3例）和VI级（8例）。肾小球硬化和间质纤维化是重要的预后指标，且与不良预后并存。EM主要在VI级进行，有助于早期肾小球硬化的识别。未发现Ki67和PCNA系膜表达与预后之间存在相关性。随着HSN分级加重，p27足细胞表达逐渐下降。