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PubMed1973

Structure and development of the glomerular crescent.

Twenty patients with idiopathic extracapillary glomerulonephritis and 16 patients with other forms of crescentic glomerulonephritis were examined by light and electron microscopy. Crescents were found to be composed of several types of cells which can be divided roughly into two groups: light and dark cells. Most of the crescent cells are apparently derived from the pariental epithelial cells of the Bowman's capsule, but at least in some cases podocytes participate in the cresent formation. Breaks in the glomerular capillary basement membrane were frequently seen (in 11 of 15 patients with idiopathic disease and in 4 of 15 other patients). Such breaks may significantly contribute to the leakage of fibrinogen and red blood cells into the Bowman's space and thus accelerate crescent formation. Proliferation of the epithelial cells appears to be related to precipitation of fibrin, though it is uncertain whether the actual stimulus is provided by the fibrin or by a coprecipitate of some normal or abnormal serum protein. Some of the proliferated cells acquire features of fibroblasts and are presumably responsible for laying down of collagen in the crescent, while other cells demonstrate phagocytic properties. These metaplastic changes of the epithelial cells are briefly discussed.

Adolescent↗
PubMed1979

[Nephrotic syndrome by diffuse mesangial sclerosis (author's transl)].

This case deals with a 15-month old male child affected with a nephrotic syndrome resulting in grave chronic renal failure, determined histologically as diffuse mesangial sclerosis. The most frequent causes of nephrotic syndrome in the first year of life are analyzed along wiht their diagnostic differential, with special attention to the Finish or microcystic congenital nephrotic syndrome and to diffuse mesangial sclerosis. In the discussion contradictions existing in the bibliography on diffuse mesangial sclerosis are shown in its clinical and developmental aspects as well as the prognostic and even in the pathological anatomy, which leads us to believe that this illness may be more complex than what it appears, and subdividing it into illnesses of different etiology, development and prognosis; or that some of the cases. described as such may not be the same as those described by R. Habib in 1973. In the present case the deposits of C3 and IgM are worth noting, as they were not described in the other 11 cases, also the study done with the electron microscope, which also was not done in the previous cases.

Complement C3↗