MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS IN THE AGED AND ITS POSSIBLECAUSAL RELATIONSHIP WITH CD8(+)CD57(+) LYMPHOCYTES

Membranoproliferative glomerulonephritis (MPGN) is a chronic progressi ve glomerulonephritis that occurs primarily in patients under the age of 30, and is rare in the elderly. We report eight aged patients with MPGN associated with CD8(+)CD57(+) lymphocytosis. All eight patients s howed a significant increase in CD8(+)CD57(+) lymphocytes with a signi ficant decrease in the ratio of CD4(+) cells to CD8(+) cells. Infiltra tion of CD8(+)CD57(+) lymphocytes was observed within capillary lumens to various degrees according to the severity of endocapillary prolife ration in each case. Expression of endothelial-leukocyte adhesion mole cule-1 was observed in a focal and segmental manner on glomerular endo thelial cells and on the endothelium of arterioles and arteries in kid ney tissue in four cases in which a pronounced endocapillary prolifera tion was simultaneously seen. These findings suggest that cell-mediate d cytotoxic mechanisms against glomerular endothelial cells may be inv olved in the pathogenesis of MPGN in the aged.