Honig C, Mouradian J A, Montoliu J, Susin M, Sherman R L
Lab Invest. 1980 Apr;42(4):427-32.
In the absence of lupus, mesangial electron-dense deposits in membranous nephropathy are thought to be uncommon. In this study 18 renal biopsies of 16 cases seen over a 2-year period were evaluated by light and electron microscopy and immunofluorescence, directing particular attention to the mesangium. Lupus had been excluded in every instance by the usual serologic tests. In seven of the 18 biopsies, mesangial electron-dense deposits were found. Clinically, almost all of these patients were characterized by atypical features: five patients had underlying diseases which have been associated with membranous nephropathy (renal vein thrombosis, epidermoid carcinoma of the lung, SH-antigenemia, rheumatic heart disease and penicillamine therapy); there was one instance of spontaneous remission and another patient who progressed to terminal renal failure in less than 2 years. The results suggest that the presence of mesangial deposits in membranous nephropathy may be more common than has previously been suspected. This finding is not necessarily associated with systemic lupus erythematosus and may indicate an unusual or atypical form of membranous nephropathy.
在无狼疮的情况下，膜性肾病中的系膜电子致密沉积物被认为并不常见。在本研究中，对2年内所见16例患者的18份肾活检标本进行了光镜、电镜及免疫荧光检查，特别关注系膜情况。通过常规血清学检测排除了所有狼疮病例。在18份活检标本中，有7份发现了系膜电子致密沉积物。临床上，几乎所有这些患者都具有非典型特征：5例患者有与膜性肾病相关的基础疾病（肾静脉血栓形成、肺表皮样癌、SH抗原血症、风湿性心脏病及青霉胺治疗）；有1例自发缓解，另1例患者在不到2年的时间里进展至终末期肾衰竭。结果提示，膜性肾病中系膜沉积物的存在可能比之前怀疑的更为常见。这一发现不一定与系统性红斑狼疮相关，可能提示膜性肾病的一种不寻常或非典型形式。
