Морфологія (Jan 2013)
Mathematical modeling in morphological differential diagnosis between mesangiocapillary glomerulonephritis type I and diffuse lupus glomerulonephritis
Abstract
Background. Diffuse lupus and mesangiocapillary glomerulonephritises have similar morphological appearance which causes difficulties of their differential diagnostics. Objective. To analyze and generalize the data about intravital investigation of renal biopsies of patients with diffuse lupus glomerulonephritis and mesangiocapillary glomerulonephritis type I and identification of their most important morphological features with the help of systematic patomorphological study and statistical methods. Methods. 39 renal biopsies of patients with diffuse lupus glomerulonephritis and 43 of biopsies of patients with mesangiocapillary glomerulonephritis were studied. Polyclonal antibodies to IgA, IgG, IgM, complement fraction С1q, С3, monoclonal antibodies to CD68, CD3, CD20, CD45, α-SMA, vimentin, desmin and polyclonal antibodies to cytokeratin (AE1/AE3 та СК18) were used. Analysis of biopsies stained with hisctochemical methods was conducted with the help of development of neuronetwork models. Results. It was revealed a number of morphological findings that play the most important role in the cases of complicated differential diagnosis between mesangiocapillary type I and diffuse lupus glomerulonephritises, such as the following: deposition of IgM in stroma, subepithelial and subendothelial deposition of complement C3 fraction, deposition of complement C3 within cylinders, deposition of complement C1q fractions inside the tubular basal membrane at the focuses with sclerosis. Conclusion. Immunohistochemical analysis with the method of neuronetwork mathematical modeling helped to reveal the most important factor evidences for differential diagnostics of glomerulonephritis.
