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Diagnosis and clinical manifestation of membranous lupus kidney
In the lupus nephritis all types of membranous lupus kidney (MLN) is relatively rare, the incidence was lower than the proliferation of lupus kidney (PLN), about 10% -20%. Hyperplasia and membranous lupus nephropathy can occur simultaneously or appear alone. MLN histological features: podocyte foot process fusion, subepithelial glomerular or segmental continuous granular deposition, often associated with mesangial deposition. This text will systematically introduce the pathologic features and clinical manifestations of MLN.
Renal biopsy is the main basis for the diagnosis of MLN, histological features of glomerular mesangial and subcutaneous immune complex deposition. The primary IgG deposition of primary membranous nephropathy (MN) was predominantly IgG4, while MLN was predominantly IgG1 and IgG3. Primary membranous nephropathy also shows IgA, IgM and C1q deposition, but not typical. Renal tubular basement membrane immunoglobulin deposition in the primary membranous nephropathy is rare, but in the MLN is relatively common.
MLN and MN pathology
More common in young female, but male is susceptible to severe MLN, the clinical features are manifestations of nephrotic syndrome. Urine microscopy or visible microscopic hematuria and erythrocyte tube type, therefore, red blood cell tube type is not III or IV lupus kidney specific performance, MLN, PLN coexistence can also occur. Antinuclear antibodies are generally positive, anti-double-stranded DNA antibodies can be positive or negative, complement levels can be normal. Thrombosis and pulmonary embolism may be the clinical features of MLN, including the renal vein, lower extremity deep vein, portal vein and inferior vena cava.
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