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1報 尿中XLFbDP量と腎糸球体像について

Abstract

Urinary levels of crosslinked fibrin degradation products (XLFbDP) in children with various renal diseases were measured by enzyme-linked immunosorbent assay (ELISA) using monoclonal antibodies, which were essentially monospecific for human D-dimer and other XLFbDP. The majority of the children with minimal change nephrotic syndrome or focal segmental glomerulosclerosis showed mild to moderately increased levels of fibrinogen degradation products (FgDP), but no excretion of XLFbDP. On the other hand, urinary excretion of XLFbDP was found in 35 of 100 patients with some type of proliferative glomerulonephritis, such as acute glomerulonephritis, membranoproliferative glomerulonephritis, rapidly progressive glomerulonephritis, lupus nephritis, purpura nephritis or IgA nephropathy, or in those with hemolytic uremic syndrome. Furthermore, in IgA nephropathy, significantly higher levels of urinary XLFbDP were found in patients with highly active proliferative lesions in their histology. Although the urinary XLFbDP levels did not correlate with the degree of intraglomerular fibrin deposits, measurement of urinary XLFbDP may provide a useful marker for active glomerular lesions such as crescents in pediatric nephritis.