IMMUNOFLUORESCENCE STUDIES OF DENSE DEPOSIT DISEASE - PRESENCE OF RAILROAD TRACKS AND MESANGIAL RINGS

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  • 1 January 1979
    • journal article
    • research article
    • Vol. 40  (4) , 474-480
Abstract
Immunopathologic analysis was carried out on renal tissue from patients with membranoproliferative glomerulonephritis, 9 with type I and 9 with type II (dense deposit disease). A specific finding in all patients with type II, but not type I, was the presence of C3 [complement component 3] along the margin but not within the central portion of dense deposit material in the glomerular basement membrane giving a double linear appearance (railroad tracks). C3 was also present within the mesangium, outlining numerous circular structures (mesangial rings). By phase contrast, EM and dual label fluorescence studies, the railroad tracks and mesangial rings outlined dense deposit material. Mesangial rings contained properdin (4 of 9 patients). Railroad tracks contained properdin (5 of 9 patients) and C4 (4 of 9 patients). No other C components or immunoglobulins [Ig] were present. Studies using rhodamine-conjugated rabbit anti-body to human glomerular basement membrane demonstrated no reactivity with the dense deposit material itself. In type I and to a lesser extent in type II, granular deposits of C3, C4, properdin, IgM and IgG were present along the glomerular basement membrane, suggesting that immune complexes play a role in both diseases. Dense deposit transformation of the glomerular basement membrane may be a consequence of a highly specific injury.