O. Hotta et al., MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS IN THE AGED AND ITS POSSIBLECAUSAL RELATIONSHIP WITH CD8(+)CD57(+) LYMPHOCYTES, Clinical nephrology, 49(3), 1998, pp. 138-144
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.