Teppo A M, Maury C P
Fourth Department of Medicine, University of Helsinki, Finland.
Rheumatol Int. 1988;8(5):213-7. doi: 10.1007/BF00269197.
The urinary excretion of immunoglobulin light chains kappa and lambda, immunoglobulin G, transferrin, and beta-2-microglobulin was studied in 21 patients with nonimmunoglobulin-related amyloid nephropathy (secondary, type AA) associated with rheumatic disease and in 39 patients with glomerulopathy of nonamyloid origin, as well as in 22 patients with rheumatic disease without signs of nephropathy and in 15 healthy subjects. Patients with amyloidosis were found to have a higher ratio of excreted lambda/kappa light chains than patients with diabetic nephropathy or chronic glomerulonephritis. The increased lambda/kappa ratio was not dependent on the grade of proteinuria and was evident in patients with mild as well as heavy proteinuria. The ratio of lambda/kappa light chains in serum of patients with amyloidosis did not differ from that in healthy controls. The results suggest that amyloid deposition in the kidneys is associated with a selective alternation of the immunoglobulin light chain excretion in the urine.
对21例与风湿性疾病相关的非免疫球蛋白相关性淀粉样肾病（继发性，AA型）患者、39例非淀粉样来源的肾小球病患者、22例无肾病迹象的风湿性疾病患者以及15名健康受试者的免疫球蛋白轻链κ和λ、免疫球蛋白G、转铁蛋白及β2微球蛋白的尿排泄情况进行了研究。发现淀粉样变性患者排泄的λ/κ轻链比值高于糖尿病肾病或慢性肾小球肾炎患者。λ/κ比值升高与蛋白尿程度无关，在轻度和重度蛋白尿患者中均很明显。淀粉样变性患者血清中λ/κ轻链比值与健康对照者无异。结果表明，肾脏中的淀粉样沉积与尿中免疫球蛋白轻链排泄的选择性改变有关。
