PATTERNS OF FIBRIN DEPOSITION IN THE GLOMERULI OF DISEASED KIDNEYS

Abstract

Immunofluorescent studies were performed on 217 percutaneous renal biopsies on patients with various renal diseases, which were examined in detail to assess the amount, character, and distribution of fibrin deposits in the glomeruli. The fibrin deposits were classified into six different forms on immunohistologic grounds. These were adhesive, adhesive and occlusive, membranous, mesangial, crescent forming, and sclerotic types. The sclerotic type was further subdivided into 2 groups: periglomerular fibrosing, and sclerosis with occlusion types. In many instances, immunofluorescence may reveal a pattern which is commonly associated with a characteristic abnormality on light microscopy. Fibrin deposits were commonly correlated with the presence of glomerular immunoglobulin and βIc/βIa-globulin. These findings interpreted as the immune reaction within glomeruli leads to an initiation of the coagulation process. The pathogenesis of each type of fibrin deposits and the sequences of glomerular hyalinization are briefly discussed.