Ian Smeeton W M, Doak P B, Simpson I J, Herdson P B
N Z Med J. 1983 Jan 26;96(724):39-42.
We have reviewed our experience of lupus nephropathy in Auckland over a 15 year period during which time 70 biopsies were obtained from 56 patients with systemic lupus erythematosus. Based on appearances by light microscopy, the biopsies were categorised as mesangial, focal, diffuse or membranous lupus nephritis. Immunofluorescence, where performed, was positive in all instances, including those biopsies showing only mesangial disease by light microscopy. By electronmicroscopy, biopsies with mesangial disease by light microscopy usually had deposits confined to the mesangium, while more severe forms of disease usually had deposits present both around the loops and in the mesangium. Clinical renal abnormalities were uncommon in the mesangial group, usual in the focal group and ubiquitous in the diffuse group. Notably, four of the 18 patients who had no clinical renal or urinary abnormalities, had focal or diffuse disease, indicating a small but definite risk of missing significant renal disease if a biopsy is not performed.
我们回顾了奥克兰地区15年间狼疮性肾炎的诊治经验，在此期间，从56例系统性红斑狼疮患者身上获取了70份肾活检样本。根据光学显微镜下的表现，活检样本被分类为系膜增生性、局灶性、弥漫性或膜性狼疮性肾炎。免疫荧光检查（如有进行）在所有病例中均呈阳性，包括那些光学显微镜下仅显示系膜病变的活检样本。通过电子显微镜检查，光学显微镜下显示系膜病变的活检样本通常沉积物局限于系膜区，而更严重的病变形式通常在袢周和系膜区均有沉积物。临床肾脏异常在系膜增生性组中不常见，在局灶性组中常见，在弥漫性组中普遍存在。值得注意的是，18例无临床肾脏或泌尿系统异常的患者中有4例存在局灶性或弥漫性病变，这表明如果不进行活检，漏诊严重肾脏疾病的风险虽小但确切存在。
