Acta Morphologica 24. (1976)
1-2. szám - Pathologia - Nagy Judit–Pár A.–Bajtai G.–Ambrus Mária–Deák G.: Membraneous Glomerulonephritis Induced by HB8 (Australia) Antigen-Antibody Complexes
9 Acta Morphologica Acad. Sei. Hung. 24 (1—2), 129 138 1976 Second Department of Medicine, First Department of Medicine, University Medical School, Pécs, Blood Transfusion Service, Pécs and Department of Pathology, University Medical School, Pécs, Hungary MEMBRANEOUS GLOMERULONEPHRITIS INDUCED BY HBS (AUSTRALIA) ANTIGEN-ANTIBODY COMPLEXES Judit Nagy, A. Pár, G. Bajtai, Mária Ambrus and G. Deák (Received March 25, 1976) The authors report a case of chronic aggressive hepatitis associated with persisting HBS (Australia) antigenaemic nephrosis. The disease proved to be membranous glomerulonephritis. Immune fluorescence revealed granular type IgG, IgM, C3 and HBS antigen deposits along the glomerular basement membrane. The IgA deposit was partly linear, partly granular. Subepithelial deposits were noted by electron microscopy along the glomerular basement membrane. It is supposed that the deposition in the glomeruli of HBS antigen—antibody immune complex was responsible for the diffuse membraneous glomerulonephritis. A notable statement of recent immunopathology is that both under experimental conditions and in certain human diseases antigen antibody complexes may develop in the presence of small antigen excess which may reach the organs through effects. Immune complex deposits in the renal glomeruli may induce glomerulonephritis by the activation of the complement and coagulation systems [2, 7, 9, 18, 21, 28, 39]. Consequently, by means of adequate morphological methods, immunocomplex-induced nephritis can be recognized in biopsy and autopsy specimens [12, 14]. The aetiology, i.e. the nature of the antigen starting the process, is still not clear [7, 16, 21]. Although the well-known role of streptococcal antigens in the development of glomerulonephritis [22, 23] cannot always be proved. Recently, more and more importance is attached to viruses or to virus induced antigens [7, 21, 28, 39]. Among these, HBS (hepatitis В surface, Australia) antigen stands in the foreground owing to its simple serological and morphological diagnostics [1, 5, 11, 14, 33, 37]. Increasing data are at disposal on the pathogenic effect of immune complexes with HBS antigen content; e.g. some cases of periarteritis nodosa [15, 25, 38], membraneous and membranoproliferative glomerulonephritis [6, 10, 19, 24] and one of focal glomerulosclerosis [19] have been reported. The present study deals with a case of membraneous glomerulonephritis associated with HBS positive, chronic aggressive hepatitis. Acta Morphologica Academiae Scientiarum Hungaricae 24, 1976