微小病变样原发性肾淀粉样变性1例误诊报告并文献复习  

Primary early renal amyloidosis:a case report and literature review

作　　者：郭永兵[1] 

机构地区：[1]河南省安阳地区医院肾内科,安阳455000

出　　处：《临床医学》2012年第1期119-121,共3页Clinical Medicine

摘　　要：目的探讨微小病变样原发淀粉样变肾病的临床病理特点及电镜检查在老年肾病中的诊断价值。方法 1例报道结合文献复习。结果早期轻微病变样淀粉样变肾病可以没有明显的临床特征,光镜下可以表现为微小病变样,确诊必须依赖电镜诊断。结论对中老年肾病综合征患者治疗前一定要做病理诊断,即使光镜检查为微小病变,也应做电镜检查是否存在淀粉样变。电镜检查对早期淀粉样变肾病而言可能是惟一可靠的诊断手段。Objective To explore the clinicopathological manifestations of minor glomerular abnormalities in the early stage of primary renal amyloidosis under the light microscopy（LM） and explain the role of electron microscopy（EM） on the diagnosis of the elderly nephropathy.Methods Case report combined with literature review.Results Minor glomerular abnormalities in the early stage of primary early renal amyloidosis had no valuable clinical hallmarks,and had no significant differences under LM.Diagnoses can only be confirmed by electron microscopy.Conclusion Renal biopsy for pathological examinations should be done before any treatment in the elderly patients with nephrotic syndrome.EM is necessary even it＇s minimal glomerular changes under LM.There are great chances that EM is the only dependable technique for the diagnosis of early renal amyloidosis.

关 键 词：淀粉样变肾病 微小病变 电子显微镜 轻链 

分 类 号：R692.9[医药卫生—泌尿科学]