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  • 1
    ISSN: 1432-2307
    Keywords: Haematuria ; Glomerular basement membrane ; Lamina densa ; Gap formation ; Silver impregnation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To elucidate the morphological basis of glomerular haematuria, morphometric analysis of the glomerular basement membrane (GBM) and lamina densa (LD) was performed on silver impregnated samples for electron microscopy. The cases studied consisted of 3 groups: group A, normal controls, being from donors for kidney transplantation; group B, haematuric; and group C, non-haematuric cases with isolated proteinuria. Qualitative analysis revealed that gap formation, splitting, segmental and diffuse thinning of the GBM occur preferentially in haematuric cases. The morphometry of the GBM and LD yielded increased mean values of the GBM and of LD thickness in groups B and C. The coefficient of variation (CV, SD/mean) for the GBM and LD, however, was the highest in group B among the 3 groups, suggesting the most irregular GBM and LD in group B. In addition, CV was significantly higher in cases with splitting, segmental attenuation and gap of the GBM than cases without. The findings suggest that the irregularity of the GBM rather than its mean thickness is clearly associated with splitting and ultimately with haematuria via the gaps produced.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Clinical and experimental nephrology 1 (1997), S. 121-130 
    ISSN: 1437-7799
    Keywords: double-contour ; mesangiocapillary glomerulonephritis ; hypocomplementemia ; IgA nephropathy ; mesangial proliferative glomerulonephritis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background To elucidate the pathologic significance of double-contour lesions of glomerular capillary walls, we determined how the clinical course of patients with diffuse and global double-contour lesions differs from that of patients with segmentally located double-contour lesions. Methods In 26 out of 308 cases of idiopathic glomerulonephritis double contour lesions and serum complement 3 (C3) deposition along capillary walls were histologically examined. Results Most patients with diffuse (affecting more than 80% of all glomeruli) and global (affecting more than 75% of each glomerulus) double-contour lesions exhibited a persistent profound proteinuria and a deterioration of renal function (assessed via serum creatinine measurements) during a mean observation period of 66 months, even when a transient remission was observed. The amelioration of hypocomplementemia correlated significantly with an improvement in proteinuria (P〈0.05). A follow-up biopsy of patients revealed some cases in which there was: (1) no amelioration of the glomerular lesion despite improvements in renal function, proteinuria and hypocomplementemia; (2) an amelioration of the glomerular lesion paralleling an increasing stability in renal function and a reduction in proteinuria; or (3) deterioration of the glomerular lesion paralleling a decrease in renal function, an increase in proteinuria, and persistent hypocomplementemia. Conclusions These findings indicate that the clinical characteristics of mesangiocapillary glomerulonephritis differ from those of other types of mesangial proliferative glomerulonephritis with segmentally-located double-contour lesions. A spot, unrepeated biopsy in cases of atypical mild mesangiocapillary lesions provides insufficient information to reach a diagnosis of mesangiocapillary glomerulonephritis.
    Type of Medium: Electronic Resource
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