@article{oai:jichi-ir.repo.nii.ac.jp:00000083,
 author = {Suzuki, Tsukasa and Maeda, Masayuki and Yoshimoto, Taichiro and Fukushima1, Noriyoshi},
 journal = {自治医科大学紀要, Jichi Medical University Journal},
 month = {Mar},
 note = {Introduction: Membranous nephropathy (MN) is a common cause of nephrotic syndrome in adults and is characterized by electron-dense deposits (EDD) in the glomerular basement membrane (GBM). On the other hand, undulations, which are formed on the epithelial side of the GBM irrelevant to EDD, are observed in some cases; these findings were not considered in the Ehrenreich and Churg (EC) classification in MN. 
Methods: Twenty adult patients with MN formed long segments of undulations on the epithelial side of the GBM without reactions to subepithelial EDD by EM were enrolled. We compared the clinicopathological findings of these cases with 20 control cases of MN patients who did not have this undulation. These two patient groups were matched for gender, age, and class of disease stage in the EC classification of MN. 
Results: In the study group, the lamina densa thickened in many areas in comparison with the control group (962.4±309.1 vs. 604.0±296.5 nm; p=0.001). In addition, the number of C3c positive cases were less in the immunofluorescence (IF) study, (n=4 vs. n=12; p=0.009), and serum complement levels tended to be higher than those in the control group. 
Conclusion: In our study, the pathogenesis of GBM undulation was not determined. Nevertheless, these results indicate that diverse immune responses, in addition to the complement system, may be involved differently from usual cases of MN.},
 pages = {11--18},
 title = {Ultrastr uctural study of the undulated epithelial side of glomer ular basement membrane in membranousnephropathy；clinicopathological study of 20 patients},
 volume = {37},
 year = {2015}
}