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Aktuelle Pathologie der Glomerulonephritis

Current problems of glomerulonephritis

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Summary

Setting out with the theory of glomerulonephritis from Volhard and Fahr (1914) and the fundamental patho-anatomical examinations on this subject by Theodor Fahr (1925, 1934) the actual problems of glomerulonephritis are described. Progress in nephropathology and immunopathology which was partly conditioned by progress in the methodical fields has come to the result that, nowadays, an appropriate characterization of glomerulonephritic diseases is only possible by the synopsis of the three categories: Immunopathogenesis, pathomorphology and clinic. Each of these categories has its own classification. The nosology of the various GN types results from the (constant or variable) combination of the components of these three systems. By this means, some known types of glomerulonephritis were confirmed, some were newly defined, and new entities with variable clinical relevance were layed bare.

Because immunopathogenetic events very often induce characteristic structural alterations in the glomeruli, it is the pathomorphological nomenclature which — aspars pro toto — still is the best suited for common interchange.

Zusammenfassung

Ausgehend von der Glomerulonephritis-Lehre von Volhard und Fahr (1914) und den grundlegenden pathologisch-anatomischen Untersuchungen zu diesem Thema von Theodor Fahr (1925, 1934) wird der aktuelle Stand der Glomerulonephritis-Problematik dargestellt. Die — z.T. methodisch bedingten — Fortschritte besonders der Nephropathologie und der Immunnephrologie haben dazu geführt, daß die sachgerechte Charakterisierung eines glomerulonephritischen Krankheitsbildes heute nur durch die Synopse der drei Kategorien — Immunpathogennese, Pathomorphologie und Klinik — möglich ist. Jede dieser Kategorien hat ihre eigene Systematik. Die Nosologie der verschiedenen GN-Formen ergibt sich aus der (konstanten oder variablen) Kombination der Einzelglieder dieser drei Systeme. Auf diese Weise sind bekannte GN-Formen z.T. bestätigt, z.T. neu definiert worden, z.T haben sich neue Entitäten mit unterschiedlicher klinischer Relevanz herausgeschält.

Da die immunpathogenetischen Vorgänge sehr häufig charakteristische Strukturenveränderungen der Glomeruli hervorrufen, ist die pathomorphologische Nomenklatur — alspars pro toto — für die allgemeine Verständigung immer noch am besten geeignet.

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  1. Pathologisches Institut der Universität Mainz, Germany

    W. Thoenes

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Nach einem Vortrag, gehalten vor dem Ärztlichen Verein Hamburg anläßlich der 100. Wiederkehr des Geburtstages von Theodor Fahr

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Thoenes, W. Aktuelle Pathologie der Glomerulonephritis. Klin Wochenschr 57, 799–814 (1979). https://doi.org/10.1007/BF01477985

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