Studies of immunological and clinicopathological aspects have been carried out in four patients with membranoproliferative glomerulonephritis (MPGN). Nine renal biopsy specimens were obtained from them during three years. Immunoserological findings were studied by examining serum immunoglobulins (Img), RA, ASLO, Wasserman reaction, anti-nuclear antibody (ab), Au antigen, anti-glomerular basement mem-brane (GMB) ab., anti-tubular BM ab., anti-mesangial ab. and others. One of the patients had positive anti-GBM ab. and his renal immunofluorescence (FAT) showed in a fashion of linear pat-tern along GBM for anti-human IgG serum. Serum Img, especially IgG, were decreased in nephrotic state. In coagulation system, fibrinogen/fibrin degradation products (FDP) in blood were normal, but urinary FDP were increased during active nephritic state, in which renal FAT showed glomerular fibrin deposition and renal histology revealed glomerular fibrin thorombi. At these state, fibrinolytic therapy with urokinase was associated with remarkable improvement of renal function tests. Serum complement studies were measured by examining CH50, alternative CH50 (ASCH50), C3, C4 and C3PA. These data suggested that complement system was activated via the classical and alternative pathway at the maximal active nephritic state. Correlation between ACH50, CH50 and complements in total and indivisual serial measurements suggested dominant complement activation via alternative pathway, but one of these cases dominant via classical pathway. C3NeF was mea-sured by using immunolectrophoresis and ACH50, but none of cases were detected. Renal histological findings showed type I in three and type ii in one. These typical histolog-ical features were fairy reversible with irreversible sclerotic changes. Renal FAT for glomerular deposits were examined by using anti-human serum for IgG, IgA, IgM, IgE, secretary piece, fibrinogen/fibrin, GBM, C3, Clq, C4, C3PA and properdin. The observa-tions indicated that deposition of complements were more dominant than that of Img and comple-ment system was more dominant via alternative pathway or Cl bypass. Correlation between renal histology, renal FAT and serum complements were relatively better. According to these data, etiology and pathogenesis were discussed in MPGN.
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