Droz D, Noel L H, Barbanel C, Grünfeld J P
Nephrologie. 1982;3(1):6-11.
188 patients with type I MPGN were followed from 1957 to 1975. At last examination, 53% of patients with pure MPGN and 66% of those with lobular MPGN had renal insufficiency; 28 other patients showed clinical improvement and 13 of these had permanent complete remission. In all of these 13 cases, (10 pure MPGN and 3 lobular forms), the clinical remission was spontaneous and occurred 2 to 16 years after the apparent onset. At the time of the first renal biopsy, 7 of these patients had a nephrotic syndrome, 2 had hypertension and 1 had renal failure. A second biopsy was obtained in 5 patients during the clinical remission period and showed in all cases a clear regression of the glomerular lesions. The possibility of spontaneous permanent clinical remission in MPGN should be considered in the indications and methods of treatment and the interpretation of their results.
188例I型膜增生性肾小球肾炎(MPGN)患者从1957年至1975年接受随访。在最后一次检查时,单纯MPGN患者中有53%以及小叶型MPGN患者中有66%出现肾功能不全;另外28例患者病情有临床改善,其中13例实现了永久性完全缓解。在这13例患者(10例单纯MPGN和3例小叶型)中,临床缓解均为自发,且发生在明显起病后2至16年。首次肾活检时,这些患者中有7例患有肾病综合征,2例患有高血压,1例患有肾衰竭。5例患者在临床缓解期进行了第二次活检,所有病例均显示肾小球病变明显消退。在MPGN的治疗指征、方法及其结果的解读中,应考虑自发永久性临床缓解的可能性。