The significance of tubulointerstitial nephritis in IgA nephritis.
The occurrence of significant tubulointerstitial nephritis (TIN) was observed in 6 (18.3%) of 32 patients with IgA nephritis registered in 1991. T lymphocytes and macrophages in the interstitium were seen to invade the tubulus through injured tubular basement membrane (TBM), then were seen in the intercellular spaces of tubular cells which showed degeneration, single cell necrosis or detachment. Thus some tubular components were seen destroyed and had disappeared resulting in interstitial fibrosis, and others showed a regeneration process forming a renewed TBM on the innerside of the original TBM. However the recurrence of cellular inflammation was again observed in these regenerated tubuli. Thus the progression of nephron loss by TIN was seen to be independent of the glomerular changes and TIN is considered to be one of the important factors in predicting the prognosis of IgA nephritis.
Shigematsu
H
H
Department of Pathology, Shinshu University School of Medicine, Matsumoto, Japan.
Kobayashi
Y
Y
Tateno
S
S
Hiki
Y
Y
Kuwao
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005922:Glomerulonephritis, IGA / Q000150:complications*; D006801:Humans; D007668:Kidney / Q000648:ultrastructure; D008264:Macrophages / Q000648:ultrastructure; D008297:Male; D008854:Microscopy, Electron; D009395:Nephritis, Interstitial / Q000150:complications* / Q000473:pathology; D011379:Prognosis; D013601:T-Lymphocytes / Q000648:ultrastructure