High Serum C3 Predicts Poor Outcome in IgM Nephropathy.

Autor: Myllymäki, Juhani, Saha, Heikki, Pasternack, Amos, Helin, Heikki, Mustonen, Jukka
Předmět:
Zdroj: Nephron Clinical Practice; 2006, Vol. 102 Issue 3/4, p122-127, 6p, 2 Charts, 3 Graphs
Abstrakt: Background: IgM nephropathy (IgMN) is an idiopathic glomerulonephritis with mesangial IgM deposition. The etiology of the depositions and possible association of serum and mesangial immunoglobulins and complement findings with renal outcome in IgMN remain unknown. Here we brought out data supplementary to our previous findings by reporting associations of immunological parameters with the outcome of IgMN. Methods: Serum IgA, IgG, IgM, C3 and C4 were measured in 110 IgMN patients by single radial immunodiffusion or nephelometry. Mesangial IgA, IgG, IgM, C1q and C3 assessed in immunofluorescent study were graded as +/–. Seven histopathological parameters were semiquantitatively graded into three classes. The relationship of serum and mesangial immunoglobulin and complement findings with the clinical outcome and prognosis of IgMN was examined. Results: We found significantly lower serum IgG and higher serum C3 levels in patients with nephrotic syndrome. Serum C3 correlated with the severity of glomerular histopathological changes. Of immu nological parameters evaluated a low serum IgG/C3 ratio correlated best with the progression of renal disease. However, serum C3 was associated indepen dently with progression in the case of patients without nephrotic syndrome. Conclusions: In addition to previously reported factors, immunological parameters may also be helpful in determining the prognosis in IgMN. High serum C3 predicts poor outcome in IgMN, being associated with high-grade proteinuria, severe histopathological changes and progression. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index