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      Relationship of Intraglomerular Coagulation and Platelet Aggregation to Glomerular Sclerosis

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          Abstract

          In order to investigate the relationship between intraglomerular coagulation and glomerular sclerosis, the distribution of fibrin-related antigen (FRA) in glomeruli without extracapillary lesions was examined by immunoperoxidase microscopy in 80 patients with IgA nephropathy (IgA-N). A total of 302 glomeruli were examined, including 20 with global sclerosis, 31 with segmental sclerosis (SS glomeruli), and 251 nonsclerosed glomeruli. In the nonsclerotic areas of SS glomeruli, the deposition of FRA was significantly greater than in the nonsclerosed glomeruli. In the nonsclerosed glomeruli FRA was mainly found in the mesangium, while in the nonsclerotic areas of SS glomeruli FRA was not only present in the mesangium but also in the endothelium of the glomerular capillary loops. FRA-positive microclots were also often observed attached to the endothelium of the capillaries of the nonsclerotic areas of SS glomeruli. Cross-linked FRA was also observed in the endothelium of the same capillaries using the monoclonal antibody DD3B6/22. Deposition of von Willebrand factor (vWF) was greater in the endothelium than in the mesangium in the same areas. Aggregated platelets adhering to the glomerular capillary walls in these areas were frequently detected using the monoclonal antibody P2. Such distribution of platelets and vWF showed that the endothelium of the nonsclerotic areas of SS glomeruli was more severely damaged than that of nonsclerosed glomeruli. These findings suggest that endothelial cell damage might activate the intraglomerular coagulation, which might be one of the factors in the development of global glomerular sclerosis.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1991
          1991
          11 December 2008
          : 58
          : 4
          : 429-436
          Affiliations
          Department of Internal Medicine, Amagasaki Hospital, Amagasaki; Amagasaki Eijinkai Hospital, Amagasaki; Department of Internal Medicine, Himeji National Hospital, Himeji; Department of Pathology and Third Division, Department of Internal Medicine, Faculty of Medicine, Kyoto University, Kyoto, Japan
          Article
          186475 Nephron 1991;58:429–436
          10.1159/000186475
          1922608
          © 1991 S. Karger AG, Basel

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          Page count
          Pages: 8
          Categories
          Original Paper

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