Sugimoto H, Makino H, Wada J, Shikata K, Ikeda S, Ota Z
Third Department of Internal Medicine, Okayama University Medical School, Japan.
Nihon Jinzo Gakkai Shi. 1993 Sep;35(9):1091-5.
A 16-year-old female was admitted to our hospital because of chance proteinuria. On admission, mild proteinuria (0.6g/day) was observed, but microhematuria was not detected during the observation period. All the values of the renal function tests were within the normal range. Her renal biopsy demonstrated a prominent increase in the mesangial area by light microscopy and showed marked paramesangial hemispherical deposits by electron microscopy. Though IgM, IgG, Clq, C3, and fibrinogen were localized in the mesangial region, IgA was not detected by immunofluorescence study. It has been reported that paramesangial hemispherical deposits are strongly indicative of IgA glomerulonephritis. We conclude that this patient is a rare case of non-IgA glomerulonephritis with huge paramesangial hemispherical deposits.
一名16岁女性因偶然发现蛋白尿入住我院。入院时观察到轻度蛋白尿（0.6g/天），但在观察期间未检测到镜下血尿。所有肾功能检查值均在正常范围内。她的肾活检在光学显微镜下显示系膜区显著增大，电子显微镜下显示明显的系膜旁半球形沉积物。尽管免疫球蛋白M、免疫球蛋白G、补体C1q、补体C3和纤维蛋白原定位于系膜区，但免疫荧光研究未检测到免疫球蛋白A。据报道，系膜旁半球形沉积物强烈提示IgA肾病。我们得出结论，该患者是一例罕见的非IgA肾病，伴有巨大的系膜旁半球形沉积物。
