高血压，大量蛋白尿，贫血，肾功能不全

Hypertension,massive proteinuria,anemia and renal dysfunction

中年女性患者,临床表现为大量蛋白尿、镜下血尿,同时血压升高伴肾功能不全及中度贫血,既往以保肾降压治疗效果不佳,至我科肾活检为肾小球结节样病变,免疫荧光染色IgG沿肾小球血管袢及肾小管基膜线样沉积,轻链染色阴性,电镜下见弥漫泥沙样高电子密度的致密物沉积于肾小球基膜内侧及远端肾小管外侧。该患者最终诊断为重链沉积病。

A middle-aged female patient presenting as massive proteinuria, microscopic hematuria,hypertension, decreased GFR and moderate anemia was reported. The renal biopsy and hisological examination was performed. The light microscope showed a nodular change of glomenali, the immunofluorescence showed IgG deposited along the glomerular tufts and tubular basement membrane, the light chain stain of renal tissue was negative. Uhrastruetural examination showed coarsely granular electron-dense deposits that delineate the outer aspect of the tubular basement membranes and endothelial aspect of the glomerular basement membrane. Finally, heavy chain deposite disease （HCDD） was diagnosed.