Abstract
A case of systemic lupus erythematosus (SLE) showing invagination of glomerular epithelial cells into the glomerular basement membrane (GBM) has been reported. The patient was a 30-year-old woman who was diagnosed with SLE at the age of 25 and had been medicated with corticosteroid. At the age of 30, she was re-admitted into our hospital because of the relapse of lupus nephritis. Renal biopsy was performed twice: at the onset of SLE and the second admission. Morphologically, the results of the first and second renal biopsies were compatible with the classification of lupus nephritis class II. Immunofluorescent study revealed the mesangial deposition of IgG, IgA, C1q, C3 and membrane attack complex (MAC) in two renal biopsies. Especially, in the second renal biopsy, numerous vesicular structures composed of a unit membrane going into the epithelial site of the GBM were observed by electron microscopy (EM), but not in the first renal biopsy. Moreover, observations of serial sections of EM suggested that these vesicular structures were invaginated into the GBM and derived from a part of the podocytes.
Similar content being viewed by others
References
Floege J, Alpers CE, Sage EH, Pritzl P, Gordon K, Johnson RJ, et al. Markers of complement-dependent and complement-independent glomerular visceral epithelial cell injury in vivo. Lab Invest. 1992;67:486–97.
Andrews P. Morphological alterations of the glomerular (visceral) epithelium in response to pathological and experimental situations. J Electron Microsc Tech. 1998;47:115–44.
Kerjaschki D. The pathogenesis of membranous nephropathy: from morphology to molecules. Virchows Arch B Cell Pathol Incl Mol Pathol. 1990;58:253–71.
Rennke HG, Klein PS. Pathogenesis and significance of nonprimary focal and segmental glomerulosclerosis. Am J Kidney Dis. 1989;13:443–56.
International Society of Nephrology Working Group on the classification of lupus nephritis: Renal Pathology Society Working Group on the classification of Lupus Nephritis The classification of glomerulonephritis in systemic lupus erythematosus revised. Kidney Int 2004;65:521–30.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Sato, M., Kogure, T. & Kanemitsu, M. A case of systemic lupus erythematosus showing invagination of the podocyte into the glomerular basement membrane: an electron microscopic observation of a repeated-renal biopsy. Clin Exp Nephrol 12, 455–461 (2008). https://doi.org/10.1007/s10157-008-0091-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10157-008-0091-0