肾脏活体组织病理检查的诊断意义推荐.ppt

IgA肾病 * Stage Proteinuria Glemerular filtration Pathology I normal normal - hyperfiltration normal - mild diffuse lesion II microalbuminuria normal - hyperfiltration normal - moderate diffuse lesionwith occasional nodular lesion IIIA persistent normal moderate diffuse lesionwith frequent nodular lesion IIIB persistent (1g=day) low (=60 ml/min) severe diffuse lesionwith frequent nodular lesion IV persistent very low end-stage kidney V Hemodialysis Diabetic Nephropathy * Diabetic Nephropathy * Diabetic Nephropathy * Diabetic Nephropathy * Diabetic Nephropathy * Diabetic Nephropathy * Diabetic Nephropathy * Diabetic Nephropathy * Diabetic Nephropathy * 膜增生性肾炎Ⅰ型 * 膜增生性肾炎Ⅰ型 * 膜增生性肾炎Ⅰ型 Moving from urinary space to capillary limen there is the urinary space, effaced foot processes, the lamina lucida externa, lamina densa, the subendothelial electron dense deposits which are lying adjacent to the little fingers of mesangial cytoplasm that have extended into the subendothelial zone, new basement membrane material, and endothelial cell with pores. * 膜增生性肾炎Ⅰ型 This electron micrograph shows the urinary space, the effaced foot processes, the original basement membrane, and conspicuous subendothelial deposits. * 膜增生性肾炎Ⅰ型 Immunofluorescence microscopy (slide 47) typically demonstrates peripheral granular or band-like staining that may outline the hypersegmentation. In many patients with type I MPGN, C3 will be the most conspicuous component in the deposits, especially in the idiopathic childhood variant. Patients with MPGN often have hypocomplementemia and a circulating autoantibody called C3 nephritic factor, which binds to the C3 convertase of the alternative pathway. * 膜增生性肾炎Ⅰ型 Hepatitis C infection is a common cause for type I membranoproliferative glomerulonephritis, especially if it is accompanied by mixed cryoglobulinemia. When mixed cryoglobulinemia is present, sometimes as shown in, there will be globular accumulations of cryoglobulin in the capillary lumens. These