SLE生検腎の血管病変の分析

抄録

Vascular lesions of small blood vessels in biopsied kidney tissues from 65 patients with SLE under long term steroid treatment were studied by light microscopy and imniunof luorescence. The intimal thickening with proliferation of elastic fibers of intralobular arteries was found in 9 cases, in whom 8 had proteinuria at the time of biopsy. In one case without proteinuria, fibrinoid degeneration was found in arterioles. Necrotizing angitis frequently observed in autopsied kidney of SLE was found in no cases. Clinical symptoms and courses of these patients were similar to those without vascular lesions. The thickening of basement membrane in addition to the proliferative changes was more prominent in these patients than those without vascular changes. All these patients showed granular deposits of IgG and/or β-1C globulin in GBM and/or mesangium. In small blood vessels, however, granular deposits were demonstrated in only one case. These results suggested that we should pay particular attention to such vascular lesions as well as glomerular lesions, when we interpret the light microscopy of kindney biopsies in patients with SLE under the long term control by steroids.