Yumura W, Nitta K, Horita S, Ozu H, Honda K, Nihei H
Department of Medicine, Tokyo Women's Medical College.
Intern Med. 1995 Jan;34(1):46-50. doi: 10.2169/internalmedicine.34.46.
A 48-year-old woman with nephrotic syndrome underwent renal biopsy. Light microscopy showed nodular sclerosis and thickening of the glomerular capillary wall. Immunoglobulins (Ig) G, especially IgG2, IgM, IgA, C3, C1q were detected along the glomerular capillary walls by immunofluorescent microscopy. Electron microscopy revealed that fibrillar materials of about 25 nm were accumulated in the subepithelial area of the glomerular basement membrane. These materials were negative for Congo-red staining. Neither cryoglobulinemia nor paraproteinemia including light chains was found. This case was diagnosed as membranous nephropathy by clinical findings and pathological examinations, and seemed to be a case of fibrillary glomerulonephritis.
一名患有肾病综合征的48岁女性接受了肾活检。光镜检查显示结节性硬化和肾小球毛细血管壁增厚。免疫荧光显微镜检查发现免疫球蛋白（Ig）G，尤其是IgG2、IgM、IgA、C3、C1q沿肾小球毛细血管壁沉积。电子显微镜检查显示，约25nm的纤维状物质积聚在肾小球基底膜的上皮下区域。这些物质刚果红染色阴性。未发现冷球蛋白血症和包括轻链在内的副蛋白血症。根据临床表现和病理检查，该病例诊断为膜性肾病，似乎是一例纤维性肾小球肾炎。
