Miyata M
2nd Department of Internal Medicine, Hirosaki University School of Medicine, Japan.
Nihon Jinzo Gakkai Shi. 1993 Sep;35(9):1051-8.
To analyze the clinical and pathological changes in systemic lupus erythematosus (SLE) patients without clinical renal abnormalities, I performed histopathological examinations of renal biopsy specimens from 40 SLE patients, who were divided into two groups. Group A consisting of 16 patients had almost no clinical evidence of renal involvement. Group B consisting of 24 patients had clinical renal manifestations, proteinuria, hematuria or both due to lupus nephritis. Light microscopy showed minor to moderate proliferative changes in the patients of Group A, and severer changes in the patients of Group B. Immunofluorescent study revealed depositions of immunoglobulins and complement in varying degrees in all the patients of Groups A and B. By electron microscopic study, electron-dense deposits and mesangial deposits were found in all patients of Group A. However, subendothelial, subepithelial and intramembranous deposits were seen in less than one-half of the patients of Group A. The amounts of the deposits were small. By contrast, a large amount of electron-dense deposits existed in the patients of Group B. The prognosis was better for patients of Group A than those of Group B. I concluded that various abnormalities of the renal glomeruli exist in SLE patients even without urinary abnormalities.
为分析无临床肾脏异常的系统性红斑狼疮（SLE）患者的临床和病理变化，我对40例SLE患者的肾活检标本进行了组织病理学检查，这些患者被分为两组。A组由16例患者组成，几乎没有肾脏受累的临床证据。B组由24例患者组成，有狼疮性肾炎导致的临床肾脏表现、蛋白尿、血尿或两者皆有。光镜检查显示A组患者有轻度至中度的增殖性改变，B组患者的改变更严重。免疫荧光研究显示A组和B组所有患者均有不同程度的免疫球蛋白和补体沉积。通过电子显微镜研究，在A组所有患者中均发现电子致密沉积物和系膜沉积物。然而，A组不到一半的患者可见内皮下、上皮下和膜内沉积物。沉积物数量较少。相比之下，B组患者存在大量电子致密沉积物。A组患者的预后比B组患者好。我得出结论，即使没有尿液异常，SLE患者的肾小球也存在各种异常。
