54 2002 3 1992 2002 3 2002 7 2004 1 15 4Kg74.0Kg 1 24 80.6 kg BUN 26.0mg/dl, s-cr 2.3mg/dl, 3+ 1 27 40 /34 174.3 cm 80.6 kg 1 10kg36.8 120/70 mmhg 88 / 14 / fibrinogen 616 mg/dl, TP 3.6 g/dl, Alb 1.4 g/dl, TC 470 mg/dl, TG 242 mg/dl, LDLcho 330 mg/dl, 8.6g/day, Alb 5.1g/day 1230.0 mg/l Ccr 24.9 ml/min, BUN 38.9 mg/dl, s-cr 3.09 mg/dl FEurea= 50.4%, FENa= 5.36% selectivity index 0.23 IgG 387 mg/dl IgA 157 mg/dl, IgM 115 mg/dl RF CRP 1.46 mg/dl, SAA 52 g/ml sil2r 1100 U/ml, IL-6 9.0 pg/ml, 305.2 ng/ml, s- 2MG 9.5 mg/l Key Word 104
WBC 5700 / l Gran 58.5% Lym 29.0% Eosin 0.3% RBC 499x10 6 / l Hb 14.8 g/dl Hct 44.40% PLT 15.3x10 3 / l PT 157% Fbg 616 mg/dl DD 0.99 g/ml GOT GPT LDH T B ALP GTP CK AMY 28 IU/l 14 IU/l 263 IU/l 0.1 mg/dl 249 IU/l 46IU/l 97 IU/l 86 IU/l TP 3.6 g/dl Alb 1.4 g/dl UN 38.9 mg/dl Cr 3.09 mg/dl UA 7.7 mg/dl Na 136 mmol/l K 4.1 mmol/l Cl 107 mmol/l c Ca 10.3 mg/dl Mg 1.9 mg/dl Pi 3.4 mg/dl TC 470 mg/dl TG 242 mg/dl HDL 36.0 mg/dl LDL-cho 330 mg/dl ACE 18.5 IU/ml/37 9.2 g/ml FBS 77 mg/dl HbA1c 5.10% CEA 3.3 ng/ml CA19-9 47.9 U/ml PSA 1.53 ng/ml CRP 1.46 mg/dl SAA 52 g/ml ASLO HCV HBs ag HBS ab HIV RF IgG 387 mg/dl IgA 157 mg/dl IgM 115 mg/dl C 3 135 mg/dl C 4 62 mg/dl CH 50 39.7U/ml DNA ds DNA RNP Sm PR3 ANCA MPO ANCA sil2r 1100 U/ml 220-530 IL-6 9.0 pg/ml <4.0 305.2 ng/ml s- 2MG 9.5 mg/l TSH 4.7 IU/ml ft3 1.10 pg/ml ft4 0.47 ng/dl PRA 12 pg/ml PAC 21 pg/ml hanp 26 pg/ml ipth 49 pg/ml BAP 23.0 U/L 1-25 OH 2VitD21.1 pg/ml Alb 36.0% 1-G 5.9% 2-G 31.5% -G 16.2% -G 10.4% Sg 1.020 ph 60 Prot 3 Sug Uro Bil RBC WBC 3-4/HPF 1-2 /HPF 1-2 /HPF M BJP LVH Ccr 24.9 ml/min UN 201.0 mg/dl FEurea= 50.4% Cr 35.8 mg/dl 1482mg/day UA 15.3 mg/dl 633mg/day Na 85.6 mmol/l FENa= 5.36% K 15.6 mmol/l Cl 94.8 mmol/l Ca 3.1 mg/dl 128mg/day Pi 13.7 mg/dl Protein 8594 mg/day Albumin 5092 mg/day 1230.0 mg/l u-alb/u-cr 343.6 mg/g Cr NAG 7.6 U/l <7.0 2MG 18180 g/l 1MG 44.3 mg/day S.I.=0.23 <0.25 105
LDH 263 IU/l transverse section peristalsis 106
u-alb 87.9mg/g Cr u-protein 3100.0mg/dl u-cr 238.8mg/dl u-alb 14.7mg/gCr u-protein 27.2mg/dl u-cr 35.4mg/dl u-alb 547.4mg/gCr u-protein 448.0mg/dl (7.6g/day) u-cr 55.9mg/dl 21 05 20 stage IgM IgG IgA 107
stage IgM selectivity index 0.23 Candesartan 2mg/ PSL40mg/ 0.82g/Ccr67.2ml/ min 108
67.8% 2 1 40 60 90% 2002 7 3 6 IgG IgG IgM IgM IgM IgM sil-2r IL-6 obstrucive nephropathy - RA 109
retroperitoneal fibrosis IL-2 IL-6 Castleman s lymphoma IL-2R lymphoma IgM IgM macromolecule IgG IgM 5 IgM M monomer IgM MRA MRA bifurcation D dimmer 5 80mg/gCr 1 3g 4g 110
contamination 3,100 2 5 2 7fluctuate 7.6 1 200cc 5 24 discrepancy discrepancy membranous GNmembranous retroperi- toneal fibrosis membranous membranous circulating immune complex brush border antigen immune complex obstruction 1 CIC immune complex immune complex C1q experimental model reflux refluxsle retroperitoneal fibrosis circulating immune complex 111
? CA19 4 1 IL-2R IL-2R 600 viral inflection CA19 malignancy periaortitis 1 MRA 120/70mmHg candesartan 2mg 2 2 incidental 1 112
1 MN hyperfiltration IgM nephropathy MN 1 UUO hyperfiltration RAS hemodynamic ARB obstructive nephropathy ARB MN ARB ARB retroperitoneal fibrosis 1977 etiology autoimmune retroperitoneal fibrosis hyperfiltration 1 PAS 113
functional overload anasaruca PAM Masson PAM bubbling IgM SABIgG granular peripheral hyaline droplet IgG dominant 2+ C3 IgM C1qmesangial pattern peripheral hump-like paramesangialmesangial matrix deposit secondary lamina densa lamina rara externa hump lamina rara externa brush borderantigen in situ deposit lamina densa fibrosis obstructive uropathy pyelo nephritis obstructive uropathy 01 reflux nephropathy obstructive uropathy 03early membranous nephropathy PAM mesangial matrix 04 bubbling spike 114
05 06 obstructive uropathy peritubular capillary polymorph polymorph 07 obstructive uropathy 08 MN secondary FGS obstructive uropathy lamina rara externa deposit spike lamina rara externa early membranes lamina rara externa Masson deposit massive deposit early membranes spike early 115
membranes 1 deposit detachment 2 selectivity index MCNS with epimembranes deposit 538 3 total protein membranous peculiar C1qsecondary membranous Passive deposit depositlucent zone third stage incorporate hump primary membranous C5b9 MAC membranous attack complex detachment 116
membranous B19 117
118
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