Ito H, Hattori S, Matusda I, Amamiya S, Hajikano H, Yoshizawa H, Miyakawa Y, Mayumi M
Lab Invest. 1981 Mar;44(3):214-20.
Immunopathologic findings in the glomeruli of six children with membranous glomerulonephritis who were carriers of hepatitis B virus were compared with serum markers of hepatitis B virus infection. Four of the patients were positive for hepatitis B e antigen (HBeAg) in the serum, were grossly proteinuric, and had abnormal liver function tests. Deposition of HBeAg, together with immunoglobulins and beta 1C, was found in the glomeruli of these patients. On electron microscopy, numerous electron-dense deposits were identified on and within the glomerular basement membrane. The remaining two patients were seropositive for antibody against HBeAg (anti-HBe); although they had previously suffered from active membranous glomerulonephritis with massive proteinuria, they were no longer proteinuric at the time of the last renal biopsy. Deposition of HBeAg was not detected in their glomeruli. Electron microscopic observation disclosed numerous electron-lucent areas which had replaced electron-dense deposits, indicating regression of the disease processes. These results delineate the etiologic role of HBeAg in maintaining active membranous changes and suggest that patients with HBeAg-mediated membranous glomerulonephritis may remit as they seroconvert from HBeAg to anti-HBe.
对6名患有膜性肾小球肾炎且为乙肝病毒携带者的儿童肾小球的免疫病理结果与乙肝病毒感染的血清标志物进行了比较。4例患者血清中乙肝e抗原（HBeAg）呈阳性，有大量蛋白尿，且肝功能检查异常。在这些患者的肾小球中发现了HBeAg与免疫球蛋白及β1C的沉积。电镜检查发现肾小球基底膜上及基底膜内有大量电子致密沉积物。其余2例患者抗HBeAg抗体（抗-HBe）血清学阳性；尽管他们曾患活动性膜性肾小球肾炎并伴有大量蛋白尿，但在最后一次肾活检时已不再有蛋白尿。在他们的肾小球中未检测到HBeAg沉积。电镜观察发现大量电子透亮区取代了电子致密沉积物，表明疾病过程在消退。这些结果阐明了HBeAg在维持活动性膜性改变中的病因学作用，并提示HBeAg介导的膜性肾小球肾炎患者在从HBeAg血清转换为抗-HBe时可能会缓解。
