Kimura T, Suzuki Y, Igarashi K, Yoshimoto K, Saima S, Nakamura Y
Department of Nephrology, National Medical Center Hospital, Tokyo, Japan.
Nihon Jinzo Gakkai Shi. 1993 Sep;35(9):1097-102.
A 47 year-old patient with an 8-year history of proteinuria was admitted to our hospital in 1989. His laboratory data were compatible with nephrotic syndrome: total serum protein 5.9g/dl (albumin 3.0g/dl), total serum cholesterol 280mg/dl and total urinary protein excretion 5.0g/day. Renal biopsy specimens contained 27 glomeruli associated with sclerosis and collapse of loops under light microscopical examination. In addition, mesangial proliferation and thickening of the basement membrane were visualized. With immunofluorescent study granular IgG deposits were detected in the peripheral region of the glomeruli. Staining for IgA, IgM, C3, Clq, light chain and Congo-red were all negative. On electron microscopy, microtubules apparently resembling cellular projections appeared to thicken the basement membrane. We are tempted to conclude that the current case is an atypical glomerulopathy accompanied by a glomerular microtubular-like structure.
一名有8年蛋白尿病史的47岁患者于1989年入院。他的实验室检查数据符合肾病综合征:血清总蛋白5.9g/dl(白蛋白3.0g/dl),血清总胆固醇280mg/dl,尿蛋白总排泄量5.0g/天。肾活检标本在光学显微镜检查下可见27个肾小球,伴有袢硬化和塌陷。此外,可见系膜增生和基底膜增厚。免疫荧光研究显示在肾小球周边区域检测到颗粒状IgG沉积。IgA、IgM、C3、Clq、轻链和刚果红染色均为阴性。电子显微镜检查显示,明显类似于细胞突起的微管似乎使基底膜增厚。我们倾向于得出结论,目前的病例是一种伴有肾小球微管样结构的非典型肾小球病。