An electron microscopic study of the glomerular epithelial detachment

Different types of the glomerular epithelial detachment have been reported in various glomerular diseases. Kidney biopsy specimens from 116 patients were investigated by electron microscopy with special attention to this lesion . The epithelial detachment was classified into 4 types: (1) glomerular...

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Published inNihon Jinzo Gakkai shi Vol. 27; no. 1; pp. 21 - 31
Main Authors SUZUKI, YASUHITO, SHIMOTORI, TAKASHI, ISHIYAMA, TAKESHI, ARAKAWA, MASAAKI, FUKAGAWA, MITSUTOSHI, KOUDA, YUTAKA
Format Journal Article
LanguageJapanese
Published Japan Japanese Society of Nephrology 1985
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ISSN0385-2385
1884-0728
DOI10.14842/jpnjnephrol1959.27.21

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Abstract Different types of the glomerular epithelial detachment have been reported in various glomerular diseases. Kidney biopsy specimens from 116 patients were investigated by electron microscopy with special attention to this lesion . The epithelial detachment was classified into 4 types: (1) glomerular basement membrane (GBM) denudation (Type I), (2) epithelial desquamation (Type II), (3) subepithelial protrusion (Type III), and (4) subepithelial expansion (Type IV). Type I was observed in almost all kinds of glomerular diseases, particularly associated with nephrotic syndrome. This lesion, however, was noticed in the cases showing only hema tuna. Type II was accompanied by either GBM abnormalities including attenuation, wrinkling, irregular thickening, splintering, and amyloid deposition, or subepithelial widening with or without electron dense deposits . Type III was seen mostly in the patients with massive proteinuria. It seemed to be the early lesion of segmental sclerosis. Type IV was the most advanced epithelial detachment seen in the sclerotic glomerular tufts. The typical lesion was observed in focal glomerular sclerosis, although it is not pathognomonic. Some of the epithelial detachment such as Type III or IV may possibly develope into segmental glomerular sclerosis, However other unknown factors may also be concerned in this process, since these detachments are commonly seen in various glomerular diseases. In conclusion, the severity of epithelial detachment is correlated with the degree of glomerular damage and proteinuria.
AbstractList Different types of the glomerular epithelial detachment have been reported in various glomerular diseases. Kidney biopsy specimens from 116 patients were investigated by electron microscopy with special attention to this lesion . The epithelial detachment was classified into 4 types: (1) glomerular basement membrane (GBM) denudation (Type I), (2) epithelial desquamation (Type II), (3) subepithelial protrusion (Type III), and (4) subepithelial expansion (Type IV). Type I was observed in almost all kinds of glomerular diseases, particularly associated with nephrotic syndrome. This lesion, however, was noticed in the cases showing only hema tuna. Type II was accompanied by either GBM abnormalities including attenuation, wrinkling, irregular thickening, splintering, and amyloid deposition, or subepithelial widening with or without electron dense deposits . Type III was seen mostly in the patients with massive proteinuria. It seemed to be the early lesion of segmental sclerosis. Type IV was the most advanced epithelial detachment seen in the sclerotic glomerular tufts. The typical lesion was observed in focal glomerular sclerosis, although it is not pathognomonic. Some of the epithelial detachment such as Type III or IV may possibly develope into segmental glomerular sclerosis, However other unknown factors may also be concerned in this process, since these detachments are commonly seen in various glomerular diseases. In conclusion, the severity of epithelial detachment is correlated with the degree of glomerular damage and proteinuria.
Author ARAKAWA, MASAAKI
SHIMOTORI, TAKASHI
SUZUKI, YASUHITO
KOUDA, YUTAKA
ISHIYAMA, TAKESHI
FUKAGAWA, MITSUTOSHI
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References 10) Jao W, et al.: Lipoid nephrosis.: An approach to the clinicopathologic analysis and dismemberment of idiopathic nephrotic syndrome with minimal glomerular change. Medicine, 52 : 445-468, 1973.
14) Churg J, LH Sobin: Renal disease, lgakushoin Tokyo New York:37-53, 1982.
7) Kanwar YS, Farquhar MG : Detachment of endothelium and epithelium from the glomerular basement membrane pyoduced by kidney perfusion with neuraminidase. Lab. Invest., 42 : 375-384, 1980.
4) Shimamura T, Morrison AB : A progressive glomerulosclerosis occurring in partial five-sixths nephrectomized rats. Am. J. Pathal. 79: 95-101, 1975.
2) Cohen AH, Mampaso F, Zamboni L : Glomerular podocyte degeneration in human renal disease. An ultrastructural study. Lab. Invest., 37 : 30-42, 1977.
6) Couser WG, Stilmant MM.: Mesangial lesions and focal glamerular sclerosis in the aging rat. Lab. Invest., 33 : 491-501, 1975.
9) Ryan GB, Karnovsky MJ.: An ultrastructural study of the mechanisms of proteinuria in amino - nucleoside nephrosis. Kidney Int., 8:219-232, 1975.
12) Olson JL, Hostetter TH, Rennke HG, Brenner BM, Venkatachalam MA,: Altered glomerular permeability and progressive sclerosis following extreme ablation of renal mass. Kidney Int., 22 : 112-126, 1982.
3) Caufield JP, Reid JJ, Farghar MG : Alterations of the glomerular epithelium in acute aminonucleoside nephrosis. Lab. Invest., 34 : 43-59, 1976.
8) Kanwar YS, Rosenzweig LJ.: Altered glomerular permeability as a result of focal detachment of the visceral epithelium. Kidney Int., 21: 565-574,1982.
5) Madrazo A, Suzuki Y, Churg J.: Radiation nephritis. Am. J. Pathol., 54 : 507-527, 1969.
11) 鈴木康二,甲田豊,荒川正昭,追手巍:糸球体基底膜anionic siteのPolyethyleneimineによる電顕的観察。腎糸球体基底膜・基礎と臨床の接点(木原達他編),西村書店,新潟,97-107,1982.
13) Velosa JA, Glasser RJ, Nevins TE, Michael AF.: Experimental model of focal sclerosis . Lab. Invest., 36 : 527-534. 1977.
1) Grishman E, Churg J : Focal glomerular sclerosis in nephrotic patients : An electron microscopic study of glomerular podocyte. Kidney Int., 7 : 111-122, 1975.
References_xml – reference: 6) Couser WG, Stilmant MM.: Mesangial lesions and focal glamerular sclerosis in the aging rat. Lab. Invest., 33 : 491-501, 1975.
– reference: 9) Ryan GB, Karnovsky MJ.: An ultrastructural study of the mechanisms of proteinuria in amino - nucleoside nephrosis. Kidney Int., 8:219-232, 1975.
– reference: 11) 鈴木康二,甲田豊,荒川正昭,追手巍:糸球体基底膜anionic siteのPolyethyleneimineによる電顕的観察。腎糸球体基底膜・基礎と臨床の接点(木原達他編),西村書店,新潟,97-107,1982.
– reference: 1) Grishman E, Churg J : Focal glomerular sclerosis in nephrotic patients : An electron microscopic study of glomerular podocyte. Kidney Int., 7 : 111-122, 1975.
– reference: 12) Olson JL, Hostetter TH, Rennke HG, Brenner BM, Venkatachalam MA,: Altered glomerular permeability and progressive sclerosis following extreme ablation of renal mass. Kidney Int., 22 : 112-126, 1982.
– reference: 14) Churg J, LH Sobin: Renal disease, lgakushoin Tokyo New York:37-53, 1982.
– reference: 2) Cohen AH, Mampaso F, Zamboni L : Glomerular podocyte degeneration in human renal disease. An ultrastructural study. Lab. Invest., 37 : 30-42, 1977.
– reference: 10) Jao W, et al.: Lipoid nephrosis.: An approach to the clinicopathologic analysis and dismemberment of idiopathic nephrotic syndrome with minimal glomerular change. Medicine, 52 : 445-468, 1973.
– reference: 8) Kanwar YS, Rosenzweig LJ.: Altered glomerular permeability as a result of focal detachment of the visceral epithelium. Kidney Int., 21: 565-574,1982.
– reference: 4) Shimamura T, Morrison AB : A progressive glomerulosclerosis occurring in partial five-sixths nephrectomized rats. Am. J. Pathal. 79: 95-101, 1975.
– reference: 7) Kanwar YS, Farquhar MG : Detachment of endothelium and epithelium from the glomerular basement membrane pyoduced by kidney perfusion with neuraminidase. Lab. Invest., 42 : 375-384, 1980.
– reference: 13) Velosa JA, Glasser RJ, Nevins TE, Michael AF.: Experimental model of focal sclerosis . Lab. Invest., 36 : 527-534. 1977.
– reference: 3) Caufield JP, Reid JJ, Farghar MG : Alterations of the glomerular epithelium in acute aminonucleoside nephrosis. Lab. Invest., 34 : 43-59, 1976.
– reference: 5) Madrazo A, Suzuki Y, Churg J.: Radiation nephritis. Am. J. Pathol., 54 : 507-527, 1969.
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Snippet Different types of the glomerular epithelial detachment have been reported in various glomerular diseases. Kidney biopsy specimens from 116 patients were...
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SubjectTerms Adult
epithelial detachment
Female
glomerular basement membrane
glomerular sclerosis
Glomerulonephritis - pathology
Glomerulosclerosis, Focal Segmental - pathology
Humans
Kidney Glomerulus - ultrastructure
Male
Microscopy, Electron
Middle Aged
Pre-Eclampsia - pathology
Pregnancy
proteinuria
Title An electron microscopic study of the glomerular epithelial detachment
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