Abstract:

Ｏｂｊｅｃｔｉｖｅ：To explore the clinical pathologic features of atypical membranous nephropathy (AMN) with special manifest of electron microscopy.
Ｍｅｔｈｏｄｏｌｏｇｙ：Eighteen patients of biopsyproven AMN with minimal glomerular change by light microscopy and few or scattered circular electron dense deposits on the epithelium of the GBM by electron microscopy were retrospectively evaluated.The clinical manifestation and pathologic features we analyzed.
Ｒｅｓｕｌｔｓ：A total of 14 women and 4 man with 12 to 64 years old were enrolled in the study.All patients had  edema and proteinuria; 3 had microscopic hematuria; 16 had the high level of urinary NacetylBDglucosaminidase to creatinine (NAG) and 8 cases had the high level of urinary retinolbinding protein(RBP).No patients had the antibody against the PLA2R.10 patients were skinflightenting creams users or had the history of hairdye.Light microscopy revealed mildly proliferative mesangial cells and mesangial matrix.Acute tubularinterstitial injury were found in six patients.The immunofluorescence findings showed granular deposits of IgG or C3 along the glomerular capillary wall.IgG1 deposits were observed along the glomerular capillary loops.The electron microscopy showed few or scattered circular electron dense deposits on the epithelium of the GBM.11 patients reached complete remission in followup after immunosuppressive therapy.
Ｃｏｎｃｌｕｓｉｏｎ：
Clinicians should improve the realization of atypical membranous nephropathy,which associated with minimal glomerular change by light microscopy and few or scattered circular dense deposits on the epithelium of the GBM by electron microscopy.

Key words: atypical membranous nephropathy, clinicopathologicalprognosis