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| 추적 신조직 검사를 시행한 낭창성 신염 5예의 병리조직학적 변화 |
| 권민중 , 최원규 , 김병길 , 홍순원 , 정현주 , 최인준 |
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| Abstract |
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The histopathological changes of lupus nephritis were investigated in 5 patients who underwent sequential renal biopsy. 3 cases showed diffuse proliferative glomerulonephritis(World Health Or- ganization class IV) and 2 cases were focal proliferative glomerulonephritis(class III) at first renal biopsy. All cases were treated with prednisolone and azathioprine. The activity of disease was monitored by measuring the anti-DNA antibody and serum complement titer serially. To watch for the side effect of azathioprine, white blood cell counts were checked serially. When the disease was activated (I.e., elevation of the titration of anti-DNA antibody or decrease of the levels of complements), pulse therapy was introduced with methylprednisolone. Second renal biopsy was performed 63 months (mean) after the initiation of treatrnent. Histo- pathologically, WHO classification improved in 4 cases and remained unchanged in a case. But, in imrnunofluorescence, the extents and intensities of imrnune deposits decreased in all cases. Activity indices decreased in all cases. But chronicity indices didn't changed in 3 cases and increased in 2 cases. Clinically, all cases had persistent normal renal function, but 1 case presented nephrotic syndrome frequently. These result confirmed that histological pattem of lupus nephritis might transform or evolve into another pattern following treatment with immunosuppressive agents. |
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