Importance of mechanical damage to urinary red blood cells by the glomerular basement membrane |
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Authors: | YUKIHIRO ISHIHARA MIYAKO MORITA TAKESHI MATSUYAMA MASAHIRO IKEDA KUZUHIKO KAWAHARA KEN KAWAMURA YASUNORI KAMIYAMA MASATAKA HONDA OSAMU HASEGAWA HIROSHI ITO |
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Affiliation: | 1. Department of Pediatrics, School of Medicine, Keio University, Tokyo, Japan;2. Department of Nephrology, Tokyo Metropolitan Children's Hospital, Tokyo, Japan;3. National Children's Hospital, Tokyo, Japan |
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Abstract: | The reasons for morphological changes of urinary red blood cells (RBC) in patients with glomerulonephritis are still controversial. In order to evaluate the importance of mechanical damage by the glomerular basement membrane (GBM), we examined urinary RBC taken from the patients with two different diseases which have characteristic GBM changes. Urinary RBC taken from 20 patients with Alport syndrome and nine with thin GBM disease were examined using a scanning electron microscope. Nineteen out of the 20 patients (95.0%) with Alport syndrome showed ‘glomerular type’, while five of the nine patients (55.6%) with thin GBM disease showed ‘glomerular type’. These results suggest that more complicated GBM abnormalities cause more severe RBC distortion. Therefore, we conclude that mechanical damage by the GBM may be the major factor in dysmorphism of urinary RBC. |
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Keywords: | Alport syndrome dysmorphic urinary RBC glomerular basement membrane (GBM) thin GBM disease |
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