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| 신증후 출혈열 환자의 이뇨기에 시행한 신생검 조직 소견과 임상 경과의 연관성 |
| 손현석 , 안재형, 이태원 , 임천규 , 김명재 , 양문호 , 김영훈 , 박원도 |
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| Abstract |
Background
Hemorrhagic fever with renal syndrome is characterized by sudden onset of fever, chills, hemorr- hagic menifestations, and renal syndrome. The path- ologic findings of kidney in patients with hemorrhagic fecer with renal syndrome are not clearly defined. Methods: To evaluate the pathologic changes of the kidney in thse patients, renal biopsies were performed in diuretic phase and the following results were obtained by the analysis of light microscopic, immunofluorescence microscopic, and electron microscopic findings. Results: 1) On light microscopic findings, renal path- ologic findings could be divided into three types; type 1 -glomerular changes (68.8%), type 2-tubulointerstitial changes (25.0%), and type 3-glomerular and tubulointer- stitial changes (6.2%). 2) On immunofluorescent microscopic findings, trace or 1(+) deposition of some immunoglobulins and complements were noted in mesangium (7, 43.8%.) and C3 in interstitial vessel wall (3, 18.8%). 3) On electron microscopic findings, mesangial elec- tron dense deposits were noted in 4 out of 16 cases (25. 0%). 4) Patients with tubulointerstitial changes had the tendency of more severe renal dysfunctions. Conclusion: Pathologic changes of the kidney were noted in glomeruli as well as tubulointerstitium in patients with hemorrhagic fever with renal syndrome. Immune deposits in mesangium and infiltratration of mononuclear cells in interstitium suggest that immune mechanism and/or direct cytotoxic effect might be implicated in renal tissue injuries. |
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