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目的探讨早期轻链沉积病(LCDD)的诊断方法。方法对临床怀疑LCDD,但肾活检光镜表现不特异的4例患者进行了肾组织免疫电镜的κ及λ轻链检查,并与免疫荧光、电镜结果及临床资料进行了对照分析。结果免疫电镜标记的胶体金颗粒与电镜下见到的电子致密物沉积一致;所标记的κ或λ与血、尿免疫电泳及免疫荧光结果一致,证明了LCDD的诊断。结论早期LCDD的诊断更应该强调免疫荧光及电镜检查的作用,免疫电镜检查有助于明确LCDD的诊断。
Objective To investigate the diagnostic method of early light chain deposition disease (LCDD). Methods Four patients with clinically suspected LCDD but no specific renal biopsy were examined by immunohistochemical method for κ and λ light chain immunohistochemistry. The results of immunofluorescence, electron microscopy and clinical data were compared. Results Immuno-electron microscopy showed that the colloidal gold particles were consistent with the electron-dense deposition observed under electron microscope. The labeled κ or λ was consistent with the results of blood and urine immunoelectrophoresis and immunofluorescence, which proved the diagnosis of LCDD. Conclusion The diagnosis of early LCDD should emphasize the role of immunofluorescence and electron microscopy. Immunoelectron microscopy can help confirm the diagnosis of LCDD.