Gouty kidney associated with membranous nephropathy: participation of renal tubular epithelial antigen.
Histological studies were performed on 3 patients with gout and proteinuria measured at 1.0 g a day or more. Light microscopy revealed diffuse thickening of the glomerular capillary walls accompanied by spike formation and bubble-like appearance as well as tophaceous granuloma in the interstitium, tubular atrophy and benign nephrosclerosis. Immunofluorescence technique showed fine granular deposits of IgG and C3 along the glomerular capillary walls together with the renal tubular epithelial antigen (RTE) in 1 patient. Subepithelial dense deposits were also observed by electron microscopy. These findings suggest that the association of membranous nephropathy should be considered in patients with gout having moderate to severe proteinuria and that RTE may be involved in the pathogenesis of subepithelial deposits in gouty membranous nephropathy.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000941:Antigens / Q000276:immunology*; D003176:Complement C3 / Q000032:analysis; D006073:Gout / Q000150:complications*; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007674:Kidney Diseases / Q000209:etiology*; D007678:Kidney Glomerulus / Q000276:immunology* / Q000473:pathology / Q000648:ultrastructure; D007684:Kidney Tubules / Q000276:immunology* / Q000473:pathology; D008297:Male; D011507:Proteinuria / Q000209:etiology
D000941:Antigens; D003176:Complement C3; D007074:Immunoglobulin G; C035812:renal tubular antigen