触须样免疫性肾小球病1例报告及超微病理学分析

摘要

目的：探讨触须样免疫肾小球病的临床病理特征、超微结构分析、诊断及鉴别诊断。方法：报道1例罕见的触须样免疫性肾小球病，应用电镜进行超微结构观察，同时结合临床、光学显微镜及免疫荧光检查、刚果红染色等进行分析探讨。结果：本例为青年女性，临床表现为蛋白尿、镜下血尿、肾病综合征。超微病理特点：系膜区及上皮下广泛性电子致密沉积物，高倍镜下为大量无分支的中空管状纤维物，直径约30 nm，成簇分布。光镜检查：刚果红染色（－）。结论：（1）与现有报道相比，该例为女性，且发病年龄较轻；（2）病变中仅见ITG典型形态学特征，就本文电镜结果所见，尚不能支持ITG和纤维性肾小球病为同一类型疾病；（3） ITG具有典型的形态学特征，电镜观察到特征性微管状结构是确诊的重要依据。%Objective: To study the ultrapathological analysis, and differential diagnosis of immunotactoid glomerulopathy ( ITG ) . Methods:One case of ITG of renal biopsy was examined by SEM, LM, IF, Congo red staining and image pattern analysis. Results:Depositions composed of regularly arranged unbranched and hollow microtubular structures appearing about 30nm in diameter in clusters were observed in the epithelial side and mesangial area. LM Congo red stain was negative. Conclusions:( 1 ) Compared with the reported cases, this case is female and much younger; ( 2 ) Only the typical morphology of the ITG was observed, which could not support the conclusion that ITG and fiber glomerular kidney glomerular disease may be of the same type;(3) The diagnosis of ITG is always based on biopsy of the kidney which reveales the characteristic of microtubule structures composed of immune reactants by electron microscopy.