Abstract:

Abstract:Objective To study the pathologic and ultrastructural features of fibrillary glomerulopathy (FGP),and provide basis for diagnosis and differential diagnosis of FGP. Methods Two renopuncture biopsy tissues of FGP（one case combined immunotactoid glomerulopathy) were studied by routine histopathological(morphologically and ultrastructurally) and were observed by light microscope with staining(HE,PAS,PAM-Masson)and immunohistochemical staining(IgG,IgM,IgA,C3,C4,C1q)and  by electron microscope with Lead citrate-Uranyl acetate staining. Results Morphologically,membranous nephropathy with immune reactants were showed in mesangium and subepithelial areas of glomerular basement membrane(GBM) in membranous glomerulopathy(MG) and membranoproliferative glomerulonephritis(MPGN) with mesangial nodular sclerosis and GBM’s double-track,which immune reactants eposited showed in subendothelial areas of GBM in MPGN by PAM-Masson staining. Renal mesangium of MG and MPGN associated with deposition of material that was positive for IgG，IgM，IgA，C3，capillary tuft of MG was positive for IgG，C3 and capillary tuft of MPGN was positive for IgM，C3，C1q by immunohistochemical staining,but they were not stained by Congo red. Ultrastructurally,the mesangial,subepithelial and/or subendothelial areas of MG and MPGN were expanded because of the electron-dense deposits,which were represented by randomly oriented nonbranching fibrils with a diameter of about 15-25 nm. In addition,microtubule deposits with a diameter of about 30-50 nm were also found in MPGN.Conclusion The diagnosis of FGP is always based on biopsy of the kidney which revealed the characteristic of fibrils composed of immune reactants under electron microscope.

Key words: kidney disease；pathology;fibrillary glomerulopathy