Membranous-like glomerulopathy with masked IgG kappa deposits

被引：62

作者：

Larsen, Christopher P. ^{[1
]}

Ambruzs, Josephine M. ^{[1
]}

Bonsib, Stephen M. ^{[1
]}

Boils, Christie L. ^{[1
]}

Cossey, Larry N. ^{[1
]}

Messias, Nidia C. ^{[1
]}

Silva, Fred G. ^{[1
]}

Wang, Yihan H. ^{[1
]}

Gokden, Neriman ^{[2
]}

Walker, Patrick D. ^{[1
]}

机构：

[1] Nephropath, Little Rock, AR 72211 USA

[2] Univ Arkansas Med Sci, Little Rock, AR 72205 USA

来源：

KIDNEY INTERNATIONAL | 2014年 / 86卷 / 01期

关键词：

glomerular disease; glomerulonephritis; glomerulopathy; kidney biopsy; membranous nephropathy; proteinuria; PROLIFERATIVE GLOMERULONEPHRITIS; IMMUNOGLOBULIN DEPOSITION; IMMUNOFLUORESCENCE; NEPHROPATHY; ENTITY;

D O I：

10.1038/ki.2013.548

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

The diagnostic classification of glomerulonephritis is determined by the interplay of changes seen using light, immunofluorescence, and electron microscopy of the renal biopsy. Routine direct immunofluorescence on fresh tissue is currently considered the gold standard for the detection and characterization of immune deposits. We recently found a peculiar form of glomerular immune complex deposition in which masked deposits required an antigen-retrieval step to be visualized. Over a 2-year period, 14 cases were characterized by numerous, large subepithelial deposits visualized by electron microscopy and C3-predominant staining by routine immunofluorescence on fresh tissue with weak to negative immunoglobulin staining. Repeat immunofluorescence after digestion of the formalin-fixed paraffin-embedded tissue with pronase elicited strong IgG-kappa staining restricted within the deposits. The patients were often young with a mean age of 26 years and commonly had clinical evidence of vague autoimmune phenomenon. The clinicopathologic findings in this unusual form of glomerulopathy do not fit neatly into any currently existing diagnostic category. We have termed this unique form of glomerulopathy membranous-like glomerulopathy with masked IgG-kappa deposits.

引用

页码：154 / 161

页数：8

共 21 条

[1]

[Anonymous], 1968, SOMMERS PATHOLOGY AN

[2] M-Type Phospholipase A(sub 2) Receptor as Target Antigen in Idiopathic Membranous Nephropathy. [J].