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KMID : 0377619750280020141
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Korean Jungang Medical Journal
1975 Volume.28 No. 2 p.141 ~ p.146
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Electon Microscopic Studies of Glomerular Lesions in the Nephrotic Syndrome due to Primary Renal Disease
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Abstract
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The nephrotic syndrome, an entity of multiple causes, is characterized by edema, proteinuria, hypercholesterolemia, and hypoalbuminemia, and it is associated with a variety of glomerular lesions.
The percutaneous renal biopsy has enabled to study the natural history of the underlying renal disease and to prognosticate more carefully the ? Outcome of therapies in the nephrotic syndrome. However, the histological changes of glomerulus are often difficult to distinguish by only light microscopy. Electron microscopy can provide the optimal means for precise diagnosis.
The present study concerned 7 patients with a nephrotic syndrome due to primary renal disease. Percutaneous renal biopsy was performed in all patients and biopsy specimens were studied by light and electron microscopy. We correlated the response to steroid therapy with pathological findings of the glomerulus.
The following results were obtained.:
1. The histological classification of the 7 nephrotic patients was divided into 3 categories: minimal change (3 patients), membranous glomerulonephritis (2) and proliferative glomerulonephritis (2).
2. Two cases, which initially diagnosed as a membranous glomerulonephritis by light microscopic study, turned out to be a minimal change by electron mieroscopic study.
3. Among 5 patients treated with prednisolone, 3 patients with a minimal change and 1 patient with a membranous glomerulonephritis expierenced a complete remission, but the another patient with a membranous ,glomerulonephritis was steroid-resistant. Spontaneous remission was seen in 1 patient with a mild proliferative glomerulonephritis.
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