caa a22 4500 445882727 CHVBK 20180317145549.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s10157-011-0528-8 doi (NATIONALLICENCE)springer-10.1007/s10157-011-0528-8 A large-sized bubbling appearance of the glomerular basement membrane in a patient with pulmonary limited AL amyloidosis and a past history of lupus nephritis [Elektronische Daten] [Norihiro Suga, Naoto Miura, Yuko Uemura, Toshinobu Nakamura, Hiroyuki Morita, Shogo Banno, Hirokazu Imai] We report an unusual pathological finding, a large-sized bubbling appearance of the glomerular basement membrane (GBM), in a patient with pulmonary limited AL amyloidosis and a past history of lupus nephritis. The first renal biopsy specimen from 10years ago, when systemic lupus erythematosus was diagnosed, demonstrated mild mesangial proliferation and subepithelial deposits (WHO classification: III+V). Light microscopy of the current biopsy using periodic acid methenamine silver (PAMS) stain demonstrated a large-sized bubbling appearance of the GBM; however, very weak immunoglobulin and complement deposition was observed in immunofluorescence studies. Routine electron microscopy demonstrated partial subendothelial expansion with electron-lucent materials, but no electron-dense deposits or amyloid fibrils. Electron microscopy with PAMS stain revealed electron-lucent endothelial scalloping, including some cellular components and microspheres in the GBM; however, it is not clear if these materials are derived from endothelial cells. One possibility is that these unique findings represent a recovery phase of lupus membranous nephritis; another is that these findings correspond to a new disease entity. Japanese Society of Nephrology, 2011 Large-sized bubbling appearance nationallicence Very weak immunoglobulin deposition nationallicence PAMS nationallicence Pulmonary limited AL amyloidosis nationallicence Lupus membranous nephritis nationallicence Suga Norihiro Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University, School of Medicine, 480-1195, Nagakute, Aichi, Japan aut Miura Naoto Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University, School of Medicine, 480-1195, Nagakute, Aichi, Japan aut Uemura Yuko Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University, School of Medicine, 480-1195, Nagakute, Aichi, Japan aut Nakamura Toshinobu Department of Internal Medicine, Meijo Hospital, Aichi, Japan aut Morita Hiroyuki Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University, School of Medicine, 480-1195, Nagakute, Aichi, Japan aut Banno Shogo Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University, School of Medicine, 480-1195, Nagakute, Aichi, Japan aut Imai Hirokazu Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University, School of Medicine, 480-1195, Nagakute, Aichi, Japan aut Clinical and Experimental Nephrology Springer Japan 15/6(2011-12-01), 970-975 1342-1751 15:6<970 2011 15 10157 https://doi.org/10.1007/s10157-011-0528-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10157-011-0528-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Suga Norihiro Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University, School of Medicine, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Miura Naoto Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University, School of Medicine, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Uemura Yuko Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University, School of Medicine, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Nakamura Toshinobu Department of Internal Medicine, Meijo Hospital, Aichi, Japan aut NATIONALLICENCE 700 1- Morita Hiroyuki Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University, School of Medicine, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Banno Shogo Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University, School of Medicine, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Imai Hirokazu Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University, School of Medicine, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 773 0- Clinical and Experimental Nephrology Springer Japan 15/6(2011-12-01), 970-975 1342-1751 15:6<970 2011 15 10157 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer