Glomerular Basement Membrane Thinning in a Patient with Hematuria and Hemoptysis Mimicking Goodpasture's Syndrome
作者:
Mark Coleman,
John W. Stirling,
Leonie R. Langford,
Peter A. Frith,
Lindsay J. Barratt,
期刊:
American Journal of Nephrology
(Karger Available online 1994)
卷期:
Volume 14,
issue 1
页码: 47-54
ISSN:0250-8095
年代: 1994
DOI:10.1159/000168685
出版商: S. Karger AG
关键词: Alveolar hemorrhage;Glomerular basement membrane thinning;Goodpasture’s syndrome;Hematuria;Hemoptysis
数据来源: Karger
摘要:
Ultrastructural morphometric studies of glomerular basement membrane (GBM) thickness are described in two renal biopsy specimens from a patient who presented with hemoptysis and hematuria mimicking Goodpasture’s syndrome. Significant GBM abnormality, with attenuation as the main lesion, identified in a biopsy specimen taken during active clinical disease appeared to have resolved in a second biopsy specimen taken during the recovery phase. There was no evidence of glomerulonephritis. Concurrent lung biopsy studies showed focal alveolar-capillary wall basal lamina changes of uncertain diagnostic significance. These observations suggest the alternative possibilities that GBM attenuation may be either an acquired consequence of systemic disease or may be part of an hitherto unrecognized primary multisystem abnormality of basal lamina affecting, in this case, glomerular and pulmonary laminae, resulting in hematuria and hemoptysis. The morphometric studies in this case indicate that simple-mean measurements of GBM thickness are inadequate alone for the quantitative study of this lamina because significant interand intraglomerular membrane variation, if irregularly distributed, can remain undetected.
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