特殊意义的轻链局限性膜性肾病1例

Membranous nephropathy with light chain-restricted deposits:a rare case report

膜性肾病(membranous nephropathy,MN)是一大类疾病,在光镜下的形态学改变类似,主要表现为基底膜增厚,可有钉突形成。原发性MN免疫荧光通常为IgG阳性,伴或不伴C3阳性,电镜下表现为上皮下大量电子致密物沉积。近年来部分单克隆免疫球蛋白相关性肾病亦可在光镜下有类似的形态学改变,我们发现了1例光镜下表现为MN,但免疫荧光提示为轻链局限性免疫球蛋白沉积,较为罕见,现予以报道。

Membranous nephropathy(MN)is a large group of diseases.MN is characterized by a pathological change in the glomerular basement membrane caused by the accumulation of immune complexes which appear as granular deposits of immunoglobulin(Ig)G when imaged with immunofluorescence with or without C3 positivity.Electron microscope shows a large amount of electron dense deposits under the epithelium.In recent years,researchers have found that some monoclonal immunoglobulin-related nephropathy can also have similar morphological changes under light microscopy.MN with light chain-restricted deposits is very rare.Here we report a case.