Ballarin J, Barcelo P, Gelpi C, Algaba F, Rodriguez J L, Corvasi A, del Rio G
Nephrologie. 1983;4(3):111-4.
An immunologic study and a renal biopsy were performed in 64 patients with isolated hematuria. Fifty of them had macroscopic hematuria and 14 microscopic hematuria. The kidney was normal in 66% by light microscopy; in the remaining 34% glomerular lesions were moderate: thickening of the mesangial matrix, diffuse or segmentary mesangial proliferation. Four patterns were observed by immunofluorescence: C3 located either in the mesangium, or at the level of the vascular pole, mesangial IgA, mesangial IgM and lack of deposits. According to our experience IgA nephropathy presenting as isolated hematuria has a better prognosis than the other symptomatic forms of this glomerulonephritis. No patient with the other renal pathological changes so far developed hypertension or renal failure. We prefer to perform biopsies on patients with isolated hematuria, considering the frequency of IgA nephropathy and the possibility of finding mesangial deposits of IgM and C3 whose significance is so far poorly known.
对64例孤立性血尿患者进行了免疫学研究和肾活检。其中50例为肉眼血尿,14例为镜下血尿。光镜下66%的肾脏正常;其余34%有中度肾小球病变:系膜基质增厚、弥漫性或节段性系膜增生。免疫荧光观察到四种模式:C3位于系膜或血管极水平、系膜IgA、系膜IgM以及无沉积物。根据我们的经验,表现为孤立性血尿的IgA肾病比该肾小球肾炎的其他症状形式预后更好。目前尚无其他肾脏病理改变的患者发生高血压或肾衰竭。考虑到IgA肾病的发生率以及发现IgM和C3系膜沉积物的可能性(其意义目前尚不清楚),我们倾向于对孤立性血尿患者进行活检。