Adhesions, focal sclerosis, protein crescents, and capsular lesions in membranous nephropathy.
All biopsies of membranous glomerulopathy collected between 1965 and 1988 (n = 198) were examined for the presence of adhesions, focal sclerosis, protein crescents, capsular drops, and other capsular lesions. These were observed with a frequency related to the number of glomeruli in the biopsy and the number of sections examined. A peculiar interrelation between these lesions was found. In the 63 cases with sufficient clinical follow-up, the capsular lesions were associated with a lower incidence of remission of the disease, and with more proteinuria and a higher serum creatinine at the last follow-up. It is hypothesized that focal detachment of podocytes may result in the formation of a protein crescent if a plasma-like filtrate is 'injected' between the epithelium of Bowman's capsule and its basement membrane. The detachment of the epithelium may lead to focal sclerosis and the formation of adhesions. The capsular drop is thought to be a final stage of inspissation of the protein crescent.
Van Damme
B
B
Department of Pathology, Universitaire Ziekenhuizen Leuven, Belgium.
Tardanico
R
R
Vanrenterghem
Y
Y
Desmet
V
V
D000328:Adult; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007678:Kidney Glomerulus / Q000032:analysis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011506:Proteins / Q000032:analysis; D012189:Retrospective Studies; D012598:Sclerosis / Q000473:pathology; D000267:Tissue Adhesions / Q000473:pathology
D011506:Proteins