小児腎疾患における尿中安定化フィブリン分解産物(XLFbDP)の動態に関する研究 ：第2報 尿中FDP分画と糸球体内フィブリン/フィブリノーゲン関連抗原(FRA)について

Abstract

In children with several kinds of renal diseases, fragments of urinary fibrin/fibrinogen degradation products (FDP) and crosslinked fibrin degradation products (XLFbDP) were investigated by autoradiography using western blotting method. Results were compared with distribution and immunological features of intraglomerular fibrin/fibrinogen related antigen (FRA) based on immunohistopathologic method containing monochloroacetic acid (MCA) treatment. In patients with minimal change nephrotic syndrome or membranous nephropathy, crosslinked fibrin (XLFb) was not present in their glomeruli, and urinary FDP were composed of fibrinogen degradation products (FgDP) such as X, Y and D. On the other hand, in cases of proliferative glomerulonephritis such as Henoch-Schönlein purpura nephritis or IgA nephropathy, XLFb was frequently observed along glomerular capillary walls. In these cases, urinary FDP were composed of XLFbDP (D-dimer) together with FgDP. It was concluded that the presence of D-dimer in the urine suggested intraglomerular XLFb, but some part of urinary FDP, especially FgDP, were derived from plasma fibrinogen or FDP.