Immunofluorescent Microscopy Versus Light Microscopy For Kidney Diseases

腎臟病之免疫螢光檢查與光學鏡檢之比較

呂福江(Fur-Jiang Leu)；何逸僊(Yat-Sen Ho)；杜炎昌(Yen-Chang Tu)；周昌德(Chang-Der Chou)；李錦發(Chin-Fa Lee)；謝善德(Shang-Der Shieh)；黃漢文(Han-Wen Hwang)

免疫螢光檢查 ； Immunofluorescent microscopy

Journal of Medical Sciences

6卷2期（1985 / 11 / 01）

149 - 158

英文

自1980年5月至1982年6月，三軍總醫院共有90例適當之活體腎臟組織做了免疫螢光和光學顯微鏡之檢視，其中有腎綜合病徵36例，急性絲球腎炎12例，IgA腎病11例，系統紅斑性狼瘡8例，慢性絲球腎炎4例，肝硬化4例和其他病症15例。於免疫螢光檢視。發現65例有一種或多種免疫球蛋白或補體之粒狀沈積，另有3例有線狀沈積。免疫螢光之發現均與普通光學鏡檢、臨床症狀和實驗室發現互做比較，可見免疫螢光檢查較光學鏡檢能有效的發現早期病變，然而免疫球蛋白之沈積機率和臨床病症之長短無明顯關係，但免疫球蛋白沈積之部位、形狀和強度在SLE病例中與光學鏡驗之期別有關。但在其他疾病却無明顯差別。臨床病徵於區別IgA腎病合併IgG與C3沈積在30例成人型腎綜合病徵，14例僅有極小之病變，8例為膜性絲球腎炎，3例為局部硬化，5例為增生性絲球腎炎。綜合而言，免疫螢光檢查確能補助一般之病理光學鏡檢，且有助對病例之深入探討。

From May 1980 to June 1982 in TSGH, totally 90 cases of adequate kidney specimens were examinated by both immunofluorescent and light microscopies. 36 cases of them were nephrotic syndrome (NS), 12 cases of them were acute glomerulonephritis (AGN), 11 of them were IgA nephropathy, 8 of them were systemic lupus erythematosus (SLE), 4 of them were chronic glomerulonephritis (CGN), 4 of them were liver cirrhosis and 15 were other cases. Immunofluorescnet microscopy (IFM) demonstrated granular deposits with one or more types of immunoglobulin (Ig) and complement (C) in 65 cases, and linear deposits in 3 cases. The IFM findings in the glomeruli were compared with the light microscopic (LM) diagnosis, the clinical symptomes and the laboratory findings. Early lesions could be detected more effectively with IFM than with LM. But the frequency of immunoglobulin deposits showed no remarkable changes as compared with the duration of clinical symptomes. The site, pattern and intensity of deposits in IFM findings of SLE cases were correlated with the stagings of this disease in LM findings; but no correlated significantly with the severity of disease in LM findings of other cases in this study. The clinical symptomes were important for differentiation of IgA nephropathy associated with IgG and C3 positive cases from Henoch-Schonlein syndrome.Among 30 cases of primary adult NS, 14 of them were minimal change disease (MCD), 8 of them were membraneous glomerulonephritis (MGN), 3 of them were focal sclerosis (FS), and 5 were proliferative glomerulonephritis (PGN). Conclusively, the IFM could be a useful complementary diagnostic tool for renal diseases.