ELECTRON MICROSCOPIC ANALYSIS OF GLOMERULAR BASEMENT MEMBRANE IN MEMBRANOUS NEPHROPATHY

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Electron microscopic observation was made on the renal biopsy specimens of eleven cases of membranous nephropathy. The renal biopsy was performed successively following the course of the disease, and immunoprotein deposits at epithelial side of glomerular basement membrane and transformation of the basement membrane were analyzed in detail, and relations of pathological findings to clinical pictures were investigated. Following results are obtained that in clinically early and active stage, the deposits are homogeneous, compact and electrondense and attached directly to fused foot-process. Projections arising from the basement membrane invade the base of the deposits and partially surround them. In advanced and inactive stage, the deposits become granular and rarefied, and come to be absorbed and organized by fine fibrils originated from the surrounding projections. One layer of new basement membrane comes to be formed at the epithelial side of the deposits. Scarcely seen are the homogeneous, compact and electron-dense deposits attached directly to fused footprocess, which are found in early and active stage. In clinically advanced and still active stage, homogeneous and compact deposits are further seen at the epithelial side of already transformed basement membrane. In conclusion, the continuation of deposition of new immunoprotein at the epithelial side of the basement membrane, and injury and destruction of the basement membrane seem to be correlated to the increase of proteinuria; and the decrease of new deposits and the appearance. of newly formed basement membrane at the epithelial side seem to be correlated to the decrease of proteinuria.

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