(thin basement membrane nephropathy) repeated hematuria IgA nephropathy?There’s also kidney disease, but the prognosis is good

2022-06-05 0 By

Clinically, there are many patients with recurrent hematuria, especially under the microscope (urine occultation blood, urine red blood cell positive), and urine protein negative and 24 hours of urine protein quantitative normal.For nephrologists, in addition to urolithiasis and urinary tract infection, recurrent hematuria is the first possibility of IgA nephropathy, but this type of nephropathy — thin basement membrane nephropathy can not be ignored.Thin basement membrane nephropathy, also known as familial recurrent hematuria, benign familial hematuria, familial hematuria syndrome, and familial recurrent hematuria syndrome, is characterized by recurrent hematuria, normal renal function, and positive family history. The renal penetrating pathology of this disease is characterized by thinning of glomerular basement membrane.The disease is often familial and may be autosomal dominant.Thin basement membrane nephropathy needs to be differentiated from IgA nephropathy, especially from IgA nephropathy of hematuria type under simple microscope.The only histopathological feature of thin basement membrane nephropathy is diffuse thinning of the glomerular basement membrane.The thickness of the glomerular basement membrane in the normal population is 300~400nm, but in this disease it is only 150~225nm.Electron microscopy is the single most important basis for the diagnosis of this disease: diffuse thinning of the glomerular basement membrane is seen under electron microscopy.The thickness of normal glomerular basement membrane varies from report to report. The thickness of normal glomerular basement membrane varies from 310-380nm in adults to 220nm (100-340nm) in children with different age groups. The average thickness of normal glomerular basement membrane increases to 310nm (180-380nm) in children with age.Generally considered diffuse basement membrane thickness for the part of the glomerular basement membrane thinning can diagnosis of thin basement membrane nephropathy is still controversial, some scholars think the glomerular basement membrane thinning of the part can be diagnosed with thin basement membrane nephropathy, but most scholars think thin basement membrane nephropathy is the glomerular basement membrane to diffuse thinning, thinning of the part is due to slice the Angle of the different.In addition to the diffuse thinning of the basement membrane, the segmental multilayer structure and electron-transparent floccule changes of the basement membrane were also observed under electron microscopy, and the foot process fusion of segmental glomerular epithelial cells was observed.The mesangial region and capillary loops generally have no electron dense deposits.Thin basement membrane nephropathy has a better long-term prognosis (i.e., no uremia) than IgA nephropathy, and the few patients who develop progressive renal failure often present with focal segmental glomerulosclerosis (i.e., FSGS nephropathy) on renal biopsy and may be co-occurring.ACEI drugs may be beneficial in patients with recurrent gross hematuria or low back pain in patients with thin basement membrane nephropathy, perhaps by reducing glomerular pressure.PS:The thin basement membrane nephropathy is the thickness of basement membrane nephropathy, in contrast to the thin basement membrane nephropathy, thick basement membrane kidney disease is caused by various reasons thickening of basement membrane of kidney disease, the most common reason is the metabolic syndrome, such as obesity, diabetes, long-term use of hormone, and so on and so forth, to be sure, thick basement membrane kidney disease do not belong to the hereditary kidney disease,Thick basement membrane nephropathy can progress to end-stage renal disease.