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Invagination and infolding of podocytes in glomerular basement membrane in the cases of primary membranous nephropathy

  • Original Article
  • Special issue Podocytic infolding glomerulopathy: a proposed new disease entity
  • Published:
Clinical and Experimental Nephrology Aims and scope Submit manuscript

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Abstract

Background

The ultrastructural findings of membranous nephropathy (MN) are well described. Recently, podocyte infolding in the glomerular basement membrane (GBM) has been observed to be a unique ultrastructural finding formed from diffuse spherical microparticles and microtubules in the GBM. However, these alterations of glomerular epithelial cells have not been well characterized in MN.

Methods

We selected 126 renal biopsies of primary MN that were diagnosed by light microscopy and immunofluorescence. In these biopsies, we investigated the ultrastructural alterations of GBM and podocytes, especially the presence of podocyte invagination, podocyte infolding, and spherical microparticles in the GBM.

Results

In 98 cases (77.8%) we ultrastructurally detected occasional invagination of podocytes in the GBM within or around electron-dense or lucent deposits in mainly stage II–III of MN. In 40 cases (31.7%), we found spherical microparticles in addition to the podocyte invaginations in the GBM. In our cases, spherical microparticles were divided into three types; podocyte infolding, cell debris and virus-like particle types. Only one case displayed numerous spherical microparticles (microspheres) that were probably caused by infolding of podocytes. These microspheres, about 80 nm in diameter, were covered by unit membrane, and were accompanied by similar-sized microtubules and protrusions of podocytes. The spherical microparticles in the other cases were associated with cell debris (n = 23) or virus-like particles (n = 16) and were not connected with podocytes.

Conclusion

Podocyte invagination associated with subepithelial deposits was a common pathological finding of primary MN, especially stage II–III of MN. The spherical microparticles in GBM in the case of MN may be associated with not only podocyte infolding but also cell debris and virus-like particles. The spherical microparticles in GBM due to diffuse podocyte infolding was considered as a new pathology finding of the GBM and may appear to be a new glomerular disease entity termed podocytic infolding glomerulopathy.

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Acknowledgments

We thank all the members of the Department of analytic human pathology, Department of Internal Medicine (Division of Neurology, Nephrology and Rheumatology), and Central Institute for Electron Microscopic Research at Nippon Medical School. We specially thank Yuichi Sugisaki, MD, PhD, for his special comments.

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Authors and Affiliations

  1. Department of Analytic Human Pathology, Nippon Medical School, 1-15 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan

    Yukinari Masuda, Akiko Mii, Akira Shimizu, Emiko Fujita, Kaoru Aki, Kahori Ishikawa, Masamichi Ishizaki & Yuh Fukuda

  2. Central Institute for Electron Microscopic Researches, Nippon Medical School, Tokyo, Japan

    Shigeru Sato

  3. Division of Neurology, Nephrology and Rheumatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan

    Naoaki Hayama, Yasuhiko Iino & Yasuo Katayama

Authors
  1. Yukinari Masuda
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  2. Akiko Mii
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  3. Akira Shimizu
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  4. Emiko Fujita
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  5. Kaoru Aki
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  6. Kahori Ishikawa
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  7. Masamichi Ishizaki
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  8. Shigeru Sato
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  9. Naoaki Hayama
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  10. Yasuhiko Iino
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  11. Yasuo Katayama
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  12. Yuh Fukuda
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Corresponding author

Correspondence to Akira Shimizu.

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Masuda, Y., Mii, A., Shimizu, A. et al. Invagination and infolding of podocytes in glomerular basement membrane in the cases of primary membranous nephropathy. Clin Exp Nephrol 12, 440–449 (2008). https://doi.org/10.1007/s10157-008-0100-3

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  • DOI: https://doi.org/10.1007/s10157-008-0100-3

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