Venkataseshan V S, Faraggiana T, Grishman E, Marquet E, Churg J
Department of Pathology, Mount Sinai School of Medicine, New York.
Clin Nephrol. 1993 Jun;39(6):321-6.
We describe two patients with nephrotic syndrome whose histologic findings on renal biopsy and at autopsy are characterized by numerous large protein casts in dilated cortical tubules, as well as podocyte swelling with effacement of foot processes in the glomeruli. Both patients progressed rapidly to renal failure. The casts and the protein precipitate in the Bowman's capsule were found to be composed of varying proportions of albumin and globulin but contained no Tamm-Horsfall protein. This suggests a glomerular rather than tubular origin of proteins. Light and electron microscopic examination of tubules revealed changes mainly due to compression by the casts. We propose that tubular obstruction due to the large casts was the main cause of renal failure.
我们描述了两名肾病综合征患者，他们肾活检和尸检的组织学结果特征为扩张的皮质肾小管中有大量大蛋白管型，以及肾小球中足细胞肿胀伴足突消失。两名患者均迅速进展为肾衰竭。发现鲍曼囊中的管型和蛋白质沉淀物由不同比例的白蛋白和球蛋白组成，但不含Tamm-Horsfall蛋白。这表明蛋白质起源于肾小球而非肾小管。对肾小管的光镜和电镜检查显示，变化主要是由管型压迫所致。我们认为，大管型导致的肾小管梗阻是肾衰竭的主要原因。
