Sawamura Masato, Sawa Naoki, Mizuno Hiroki, Oba Yuki, Ikuma Daisuke, Sekine Akinari, Yamanouchi Masayuki, Hasegawa Eiko, Suwabe Tatsuya, Suzuki Masanori, Kono Kei, Kinowaki Keiichi, Ohashi Kenichi, Ehara Takashi, Ikeda Yoichiro, Sawai Toshihiro, Ubara Yoshifumi
Nephrology Center and Department of Rheumatology.
Okinaka Memorial Institute for Medical Research, Toranomon Hospital.
Clin Nephrol Case Stud. 2023 Jun 8;11:87-94. doi: 10.5414/CNCS111091. eCollection 2023.
We performed a kidney biopsy in a 36-year-old man to evaluate microscopic hematuria and proteinuria. Light microscopy showed increased mesangial matrix and partial swelling of the glomerular basement membrane (GBM), and immunofluorescence showed positive staining only for C3. Immunoelectron microscopy showed that gold particle-labeled C3 was localized in the electron-dense and moderately electron-dense deposits shown by electron microscopy in the mesangium, the thickened GBM near the paramesangium, and the thickened distal portion of the GBM but was not localized in the non-thickened GBM. Gold-labeled immunoglobulin G, κ, and λ were not seen. C3 glomerulonephritis was more evident in gold-labeled electron microscopy, which further clarified the localization of C3 deposition.
我们对一名36岁男性进行了肾活检,以评估镜下血尿和蛋白尿。光镜检查显示系膜基质增加和肾小球基底膜(GBM)部分肿胀,免疫荧光检查仅显示C3呈阳性染色。免疫电子显微镜检查显示,金颗粒标记的C3定位于系膜区、系膜旁增厚的GBM以及GBM增厚的远端部分电子显微镜下显示的电子致密和中度电子致密沉积物中,但未定位于未增厚的GBM。未见到金标记的免疫球蛋白G、κ和λ。金标记电子显微镜下C3肾小球肾炎更为明显,进一步明确了C3沉积的定位。