Korean Journal of Nephrology 1994;13(3):576-585.
전자간 신병증
채현기 , 김정호 , 강종명 , 박문향
Abstract
Preeclampsia is a condition peculiar to pregnancy which produces characteristic morphological glome- rular changes. In order to clarify the renal changes in preeclampsia, renal biopsy was reviewed from 8 women who had a history of preeclampsia and who were biopsied. Clinical diagnoses were severer preeclampsia in 4, preeclampsia with nephrotic syndrome in 2, pree- clampsia with glomerulonephritis including mixed con- nective tissue disease(MCTD) and IgA nephropathy in 2, who had electron microscopic (EM) changes of preeclamptic nephropathy superimposed on MCTD and IgA nephropathy. All showed varying degree of endothelial swelling and luminal narrowing. Four showed focal segmental or global sclerosis either in light microscopy (LM) or EM. Deposits of fibrin along the glomerular capillary wall were demonstrated in 5 cases among 7 immunofluorescent (IF) samples. IgM, IgA, Cg, C, C were weakly positive in the half of the cases. Clinical symptoms resolved in 60 days after postpartum except for 3 cases, of which two cases were' superimposed with underlying renal desease. The characteristic morphological glomerular changes associated with preeclamsia were identified in all cases. In addition to these findings, hyaline arteriolosclerosis was present in 5 cases, among these moderate degree of arteriolosclerosis associated with focal ischemic collapse of glomeruli was noted in 2 cases, one of which was advanced IgA nephropathy. However, only one case among two cases showing early changes of focal seg- mental glomerulosclerosis (FSGS) by LM displayed mild arteriosclerosis and arteriolosclerosis. In two cases with moderate degree of arteriosclerosis, EM study revealed segmental sclerosis and ischemic change of glomeruli suggesting that this segmental sclerosis appeared to be an ischemic nature induced by the ongoing hypertensive process rather than primary FSGS.
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