[Clinico-morphologic heterogeneity of minimal changes in glomerulonephritis]

60 kidney biopsies from patients with minimal changes were investigated by light-, electron- and immunofluorescent microscopy. The clinical picture in 41 patients was nephrotic syndrome; 10, 6 and 3 patients had mixed, hematuric and latent forms, respectively. In 45 of 60 biopsies focal or diffuse deposits of immune complexes in basal membrane and glomerular mesangium were found. 15 cases proved to be immunonegative. Depending on various combinations of G, A, M-immunoglobulins, C3-fraction of complement, their location in the glomerulus and type of the immune complex fluorescence, one can say about glomerulonephritis, focal segmental glomerular hyalinosis or membranous nephropathy. The immunonegative group of minimal changes requires an electron-microscopic study which may determine the nosology of minimal changes: lipoid nephrosis, disease of thin basal membranes, hypoplastic dysplasia. Recognition of glomerulonephritis and independent forms of glomerulopathies in minimal changes having their immunohistochemical characteristics and other features suggest clinicomorphological heterogeneity of minimal changes.