Kidney disease

Pathol Res Pract. 1980 May;167(1):88-117. doi: 10.1016/S0344-0338(80)80183-X.

Abstract

The diagnostic highlights under electron microscopy in hereditary nephropathies and glomerulonephritides are reviewed: Alport's syndrome--lamellation, fragmentation and reticulation of glomerular basement membrane; benign essential (familial) hematuria--glomerular basement membrane thinning; nail patella syndrome--moth eaten holes and collagen like fibrils in glomeruli; nephronophthisis--thickening, thinning, reticulation and loss of tubular basement membrane; intramembranous and epimembranous glomerulonephritis--unequivocal diagnosis in early and late stages; extracapillary glomerulonephritis--exact classification of the basic type of glomerulonephritis; segmental focal sclerosing glomerulonephritis--unequivocal diagnosis of early stages and differentiation from other forms of glomerulonephritis or other nephropathies; Schönlein-Henoch's syndrome--scanty subepithelial deposits encases by a thin lamella of lamina densa; SLE--deciphering mixed forms of glomerulonephritis and demonstration of virus-like tubular structures in endothelium, so-called organized deposits, interstitial immunocomplex nephritis; mixed IgG/IgM cryoglobulinaemia--crystalloid structure of deposits; IgA nephritis--unequivocal demonstration of mesangial deposits; congenital nephrotic syndrome--irregularity of glomerular basement membrane and finally amyloidosis--unequivocal diagnosis. It is concluded that electron microscopy contributes information of clinical relevance in 30% of cases. Thus, electron microscopy should be used (in addition to light microscopy and immunofluorescence), whenever a renal biopsy specimen is to be critically evaluated.

MeSH terms

  • Cryoglobulins
  • Glomerulonephritis / pathology
  • Hematuria / pathology
  • Humans
  • IgA Vasculitis / pathology
  • Immunoglobulin G
  • Immunoglobulin M
  • Kidney / ultrastructure
  • Kidney Diseases / pathology*
  • Lupus Erythematosus, Systemic / pathology
  • Microscopy, Electron
  • Nail-Patella Syndrome / pathology
  • Nephritis / pathology
  • Nephritis, Hereditary / pathology
  • Nephrotic Syndrome / pathology
  • Paraproteinemias / pathology

Substances

  • Cryoglobulins
  • Immunoglobulin G
  • Immunoglobulin M