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慢性膜增生性肾小球肾炎(MPGN)中的免疫荧光模式。

Immunofluorescence patterns in chronic membranoproliferative glomerulonephritis (MPGN).

作者信息

Belgiojoso G B, Tarantino A, Bazzi C, Colasanti G, Guerra L, Durante A

出版信息

Clin Nephrol. 1976 Jul;6(1):303-10.

PMID:782750
Abstract

90 patients, whose renal biopsies showed on light microscopy a pattern of MPGN, have been studied by immunofluorescence. 10 cases showed dense intramembranous deposits. Fluoresceinated antisera against IgG, IgA, IgM, C3, fibrinogen, IgD, IgE, C4, C1q, properdin and C3A were employed. Granular depostis of C3 were observed in all cases; IgG, IgM, properdin, C1q and C4 were found in 2/3 cases; IgA, IgE and C3A were rarely found. The localization of these deposits was parietal and often also mesangial. On the basis of glomerular deposition of C3 with or without immunoglobulins (Ig), we separated the cases into three groups: 1) C3 + Ig (59 cases), 2) predominant C3 (19 cases), 3) isolated C3 (12 cases). Most patients with dense deposits disease were classified in the third group. Deposits of C1q and C4 were found only in the first two groups. The localization of C3 deposits showed a more frequent mesangial extension in the second and third groups. Patients in these 3 groups also had different serum complement profiles. No significant differences in the major clinical features could be found in the 3 groups. Variable immunofluorescence patterns, in agreement with other serological parameters, confirm the heterogeneity of pathogenetic mechanisms in patients with MPGN.

摘要

90例肾活检光镜显示膜增生性肾小球肾炎(MPGN)模式的患者接受了免疫荧光研究。10例显示有致密的膜内沉积物。使用了针对IgG、IgA、IgM、C3、纤维蛋白原、IgD、IgE、C4、C1q、备解素和C3A的荧光抗血清。所有病例均观察到C3颗粒状沉积物;2/3病例中发现了IgG、IgM、备解素、C1q和C4;IgA、IgE和C3A很少发现。这些沉积物的定位在壁层,且通常也在系膜区。根据C3在肾小球的沉积情况有无免疫球蛋白(Ig),我们将病例分为三组:1)C3+Ig(59例),2)以C3为主(19例),3)孤立C3(12例)。大多数致密沉积物病患者被归入第三组。C1q和C4沉积物仅在前两组中发现。C3沉积物的定位在第二组和第三组中显示系膜延伸更频繁。这三组患者的血清补体谱也不同。三组患者的主要临床特征未发现显著差异。与其他血清学参数一致的可变免疫荧光模式证实了MPGN患者发病机制的异质性。

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