Ishihara T, Akamatsu A, Takahashi M, Yamashita Y, Yokota T, Nagasawa T, Gondo T, Kawano H, Kawamura S, Uchino F
First Department of Pathology, Yamaguchi University School of Medicine, Ube, Japan.
Acta Pathol Jpn. 1988 Mar;38(3):339-50. doi: 10.1111/j.1440-1827.1988.tb02306.x.
The biopsied kidneys from three patients with hepatitis Be antigen (HBeAg)-associated nephropathy were observed by light microscopy, immunohistochemistry and electron microscopy. By an indirect technique utilizing horseradish peroxidase-conjugated antisera, HBeAg was found to be deposited in a diffuse granular fashion along the glomerular capillary wall. No deposition of hepatitis Bs or hepatitis Bc antigen was detected. The three cases were diagnosed as HBeAg-associated nephropathy. Ultrastructurally, there were finely granular electron-dense deposits in the subendothelial area, basement membrane, mesangial area and subepithelial area of the glomerular tufts. In all three cases, virus-like particles between 30 and 70 nm in diameter were also found in such areas of the glomerular tufts, and rarely in the glomerular capillary lumen and space of Bowman. They occasionally formed clusters in the phagosomes of mesangial cells. In addition, tubulo-reticular structures were noted in the cytoplasm of endothelial cells in the glomerular capillaries. The presence of HBeAg both in the serum and in the kidney and of virus-like particles in the glomerular tufts suggests that HBeAg is causally related to the development of HBeAg-associated nephropathy.
对3例乙肝e抗原（HBeAg）相关性肾病患者的活检肾脏进行了光镜、免疫组化和电镜观察。通过利用辣根过氧化物酶偶联抗血清的间接技术，发现HBeAg以弥漫性颗粒状沿肾小球毛细血管壁沉积。未检测到乙肝表面抗原（HBsAg）或乙肝核心抗原（HBcAg）的沉积。这3例病例均诊断为HBeAg相关性肾病。超微结构上，在肾小球襻的内皮下区域、基底膜、系膜区和上皮下区域有细颗粒状电子致密沉积物。在所有3例病例中，在肾小球襻的这些区域也发现了直径在30至70纳米之间的病毒样颗粒，在肾小球毛细血管腔和鲍曼间隙中很少见。它们偶尔在系膜细胞的吞噬体中形成簇。此外，在肾小球毛细血管内皮细胞的细胞质中发现了管网状结构。血清和肾脏中均存在HBeAg以及肾小球襻中存在病毒样颗粒，提示HBeAg与HBeAg相关性肾病的发生有因果关系。
