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KMID : 0378019720150010058
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New Medical Journal
1972 Volume.15 No. 1 p.58 ~ p.70
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Electron microscopic and light microscopic studies on biopsy material among the patuents with nephrotic syndrome
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Abstract
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The nephrotic syndrome is a clinical term useful in describing patients with massive proteinuria, hypoalbuminemia, hyperlipidemia and edema. Other terms have been used to describe the various clinical forms of the syndrome and its relationship to a variety of pathologic lesions, namely, nephrosis, pure nephrosis, lipoid nephrosis and nephrosonephritis. The syndrome may occur in association with certain recognizing disorders. Thus it may occur:
1. In various systemic diseases which affected the kidneys, such as diabetes mellitus, systemic lupus erythematosus, amyloidosis, syphilis.
2. During the course of a chronic glomerulonephritis which was preceded months or years before by recognized attack of acute glomerulonephritis.
3. Following renal vein thrombosis or constrictive pericarditis.
4 As a result of drug toxicity (tridion, gold, bithmus etc.) or allergic manifestations (poison oak, bee stings etc. ).
And it also occurs due to intrinsic renal disease, the so-called primary form of the syndrome, the glomerular changes as revealed by percutaneous renal biopsies are variable and multiple. The response to steroid therapy and clinical course are also variable. This paper represents a study of 5 adult patients, suffering from the nephrotic syndrome based on the criteria with proteinuria, hypoproteinemia, edema, hyperlipidemia, sedimenturia, normal blood pressure and usually normal conventional renal function tests, in an attempt to review the details of the clinical, laboratory and pathological findings by electron microscopic and light microscopic studies and correlated with corticosteroid therapy.
The following conclusions are drawn: Histologic findings on renal biopsy specimen demonstrated that five types such as membranous type, probable proliferative type, chronic glomerulonephritis, lipoid nephrosis, and mixed type, respectedly.
Complete remission was induced in no case with steroid therapy. However, purely proliferative glomerulonephritis appeared to respond better to steroid therapy with patient showing incomplete remission in both cases.
Fusion of foot process was seen in 4 cases among 5 cases while the thickening of basement membranes
were noted in all cases on electron microscopic study.
Pathologic changes were seen in epithelial cell, such as increased number of lysosome and vaculoles, "dense body, dilatation of subbasilar spaces and proliferation of mesangial cell on electron microscopic study which were not recognized by light microscopic study.
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