A case of unilateral lymphedema with IgA nephropathy

doi:10.3877/cma.j.issn.2095-3216.2020.05.011

Chinese Journal of Kidney Disease Investigation(Electronic Edition) ›› 2020, Vol. 09 ›› Issue (05): 238-239. doi: 10.3877/cma.j.issn.2095-3216.2020.05.011

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A case of unilateral lymphedema with IgA nephropathy

Xiaowei Sun¹, Jinling Meng¹, Jing Cui¹

Received:2020-05-09 Online:2020-10-28 Published:2020-10-28

Abstract

Xiaowei Sun, Jinling Meng, Jing Cui. A case of unilateral lymphedema with IgA nephropathy[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2020, 09(05): 238-239.

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		左肾	右肾
肾小球	硬化程度	全球硬化65%	未见全球及节段硬化
	系膜细胞	局灶、节段、中度增殖	局灶、节段、轻度增殖
	内皮细胞	局灶、节段增殖、肿胀	未见增殖
	上皮细胞	节段增殖	未见增殖
	基底膜	基底膜增厚，可见"双轨样"结构	基底膜不厚，未见钉突及双轨
肾小管		多灶性、中度萎缩	小灶性、轻度萎缩
肾间质		炎细胞多灶性、中度浸润	炎细胞小灶性、轻度浸润
肾内动脉		动脉壁增厚，可见"洋葱皮"样改变，细小动脉广泛玻璃样变	动脉壁增厚
免疫荧光表现		IgA(2＋)、C3(＋)系膜区团块样沉积，IgA(＋)、C3(＋)血管袢颗粒样沉积	IgA(2＋)、C3(＋)系膜区团块样沉积
电镜表现		系膜区可见电子致密物成绩，符合IgA肾病	未做
病理诊断		IgA肾病(Lee分级Ⅳ级)伴恶性肾小动脉硬化	IgA肾病

		左肾	右肾
肾小球	硬化程度	全球硬化65%	未见全球及节段硬化
	系膜细胞	局灶、节段、中度增殖	局灶、节段、轻度增殖
	内皮细胞	局灶、节段增殖、肿胀	未见增殖
	上皮细胞	节段增殖	未见增殖
	基底膜	基底膜增厚，可见"双轨样"结构	基底膜不厚，未见钉突及双轨
肾小管		多灶性、中度萎缩	小灶性、轻度萎缩
肾间质		炎细胞多灶性、中度浸润	炎细胞小灶性、轻度浸润
肾内动脉		动脉壁增厚，可见"洋葱皮"样改变，细小动脉广泛玻璃样变	动脉壁增厚
免疫荧光表现		IgA(2＋)、C3(＋)系膜区团块样沉积，IgA(＋)、C3(＋)血管袢颗粒样沉积	IgA(2＋)、C3(＋)系膜区团块样沉积
电镜表现		系膜区可见电子致密物成绩，符合IgA肾病	未做
病理诊断		IgA肾病(Lee分级Ⅳ级)伴恶性肾小动脉硬化	IgA肾病

[1]	Baluk P, Fuxe J, Hashizume H, et al. Functionally specialized junctions between endothelial cells of lymphatic vessels [J]. J Exp Med, 2007, 204(10): 2349-2362.
[2]	Solito R, Alessandrini C, Fruschelli M, et al. An immunological correlation between the anchoring filaments of initial lymph vessels and the neighboring elastic fibers: a unified morphofunctional concept [J]. Lymphology, 1997, 30(4): 194-202.
[3]	Podgrabinska S, Braun P, Velasco P, et al. Molecular characterization of lymphatic endothelial cells [J]. Proc Natl Acad Sci USA, 2002, 99(25): 16069-16074.
[4]	Usta M, Dilek K, Ersoy A, et al. A family with IgA nephropathy and hereditary lymphoedema praecox [J]. Int Med, 2002, 251(5): 447-451.
[5]	Zhang T, Guan G, Liu G, et al. Disturbance of lymph circulation develops renal fibrosis in rats with or without contralateral nephrectomy [J]. Nephrology (Carlton), 2008, 13(2): 128-138.

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