A case of IgA nephritis showing diffuse podocytic detachment from the glomerular basement membrane.

MORIYA TATSUMI, NAKAZAWA KOH, ITOH NOBUO, SHIGEMATSU HIDEKAZU, HIGUCHI MAKOTO, MIYASAKA MAKOTO, OGUCHI HISAO

doi:10.14842/jpnjnephrol1959.34.423

A case of IgA nephritis showing diffuse podocytic detachment from the glomerular basement membrane.

DOI PubMed

MORIYA TATSUMI

Departments of Pathology, Shinshu University School of Medicine
NAKAZAWA KOH

Departments of Pathology, Shinshu University School of Medicine
ITOH NOBUO

Departments of Pathology, Shinshu University School of Medicine
SHIGEMATSU HIDEKAZU

Departments of Pathology, Shinshu University School of Medicine
HIGUCHI MAKOTO

Internal Medicine (II), Shinshu University School of Medicine
MIYASAKA MAKOTO

Internal Medicine (II), Shinshu University School of Medicine
OGUCHI HISAO

Internal Medicine (II), Shinshu University School of Medicine

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説明

We report the case of a 15-year-old Japanese female with severe mesangial proliferative IgA glomerulonephritis who showed a dramatic response to cocktail therapy for nephrotic syndrome. She had suddenly developed massive proteinuria and microscopic hematuria. The first renal biopsy at one month after onset revealed severe mesangial hypercellularity and podocytic detachment from the glomerular basement membrane (GBM). The cocktail therapy resulted in a decrease of proteinuria clinically, and a second biopsy demonstrated repair of the podocytic detachment. We suggest that the massive proteinuria in this case was due to destruction of the size barrier by detachment of podocytes from the GBM, and the repair of the podocytic covering on the GBM was accelerated by the cocktail therapy.